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Wise et al.

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Author Manuscript Author Manuscript Author Manuscript Author Manuscript TABLE VIII.A. Evidence for the role of history taking and physical examination in the diagnosis of allergic rhinitis Study Year LOE Study design Study groups Clinical endpoint Conclusion Raza et al. 781 2011 3b Cross sectional Adults with AR History, physical examination, SPT Physical examination alone yields unreliable and inconsistent results in diagnosing AR. Costa et al. 780 2011 4 Cohort study Adults with AR Physician interview and structured questionnaire Many patients diagnosed on history alone without confirmatory testing. Shatz 778 2007 4 Survey 1 Adults and children >12 years with AR; 2 Physicians of group 1 Self-completed patient questionnaire, physician patient record form Persistent AR patients reported more symptoms than intermittent AR patients. Ng et al. 779 2000 4 Case-control Adults with AR History, physical examination, SPT, sIgE Rhinorrhea, sneezing, sniffing, impaired sense of smell, blocked nose, edematous nasal mucosa, and itchy nose ranked highest in diagnostic utility. Physical examination performed to eliminate other potential causes of symptoms. Seidman et al. 761 2015 5 Guideline Recommendations on diagnosis and treatment of AR Clinical diagnosis of AR made with a history and physical examination consistent with AR. Wallace et al. 26 2008 5 Guideline Recommendations on the diagnosis and treatment of rhinitis Thorough allergic history remains the best diagnostic tool available. All organ systems potentially affected by AR should be examined. Typical allergic exam findings are supportive but not specific. Small et al. 777 2007 5 Guideline Recommendations on diagnosis and treatment of rhinitis Bousquet et al. 7 2001 5 Guideline Recommendations on the diagnosis and treatment of AR in asthmatic patients

History of allergic symptoms is essential in the diagnosis of AR. Physical exam aids in supporting the diagnosis of AR.

Symptom type and timing (obtained through history) is essential to correct diagnosis. Lung exam is recommended in asthmatic patients with symptoms of AR.

AR = allergic rhinitis; LOE = level of evidence; sIgE = antigen-specific immunoglobulin E; SPT = skin prick test.

Int Forum Allergy Rhinol . Author manuscript; available in PMC 2020 June 10.