The diagnosis of allergic rhinitis: how to combine the medical history with the results of radioallergosorbent tests and skin prick tests

Scand J Prim Health Care. 1998 Mar;16(1):30-6. doi: 10.1080/028134398750003377.


Objective: To identify the most useful combinations of symptoms and the results of radioallergosorbent tests (RASTs) and skin prick tests (SPTs) for the diagnosis of allergic rhinitis.

Design: A prospective comparison was made of symptoms and the results of RASTs and SPTs with 7 different nasal allergies; the references used were the "consensus diagnoses" provided by 3 experts.

Setting: Nineteen general practices in The Netherlands.

Patients: 365 consecutive patients aged 12 or over who visited their general practitioner because of chronic or recurrent nasal symptoms between 1 March 1990 and 1 March 1991.

Main outcome measures: The most useful combinations of items from the history, RASTs, and SPTs, for the diagnosis of 7 different nasal allergies; the predictive probabilities of these combinations.

Results: Diagnostic criteria could be drawn up resulting in a near-perfect discrimination between patients diagnosed as having allergic rhinitis and patients diagnosed as not having allergic rhinitis. Most of these criteria combined only a single item from the history with either RAST or SPT. For nearly all nasal allergies, both the negative predictive probabilities and the positive predictive probabilities were 97% or more.

Conclusions: The common nasal allergies can be diagnosed with a very high certainty with the aid of simple diagnostic criteria. Data from a strictly limited case history combined with either RAST or SPT are sufficient.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Family Practice
  • Female
  • Humans
  • Intradermal Tests*
  • Logistic Models
  • Male
  • Medical History Taking*
  • Middle Aged
  • Netherlands
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • Radioallergosorbent Test*
  • Rhinitis, Allergic, Perennial / diagnosis*
  • Rhinitis, Allergic, Seasonal / diagnosis*