Catching allergy by a simple questionnaire

Maurizio Galimberti, Giovanni Passalacqua, Cristoforo Incorvaia, Vincenzo Castella, Maria Teresa Costantino, Beniamino Cucchi, Sebastiano Gangemi, Gilda Nardi, Paolo Raviolo, Paola Rottoli, Nicola Scichilone, Nico Sciolla, Germano Bettoncelli, Massimo Landi, Erminia Ridolo, Serena Buttafava, Paola Puccinelli, Giorgio Walter Canonica, Alessandro Fiocchi, Franco Frati

Identifying allergic rhinitis requires allergy testing, but the first-line referral for rhinitis are usually primary care physicians (PCP), who are not familiar with such tests. The availability of easy and simple tests to be used by PCP to suggest allergy should be very useful. The Respiratory Allergy Prediction (RAP) test, based on 9 questions and previously validated by a panel of experts, was evaluated in this study. An overall number of 401 patients (48.6% males, age range 14-62 years) with respiratory symptoms was included. Of them, 89 (22.2%) showed negative results to SPT, while 312 (77.8%) had at least one positive result to SPT. Cohen's kappa coefficient showed that all questions had an almost perfect excellent agreement between pre and post-test. The algorithm of decision-tree growth Chi-squared Automatic Interaction Detector showed that answering yes to the question 4 (Your nasal/ocular complains do usually start or worsen during the spring?), 6 (Did you ever had cough or shortness of breath, even during exercise?) and 8 (Do you use nasal sprays frequently?) gave a probability to have a positive SPT of 85%. These findings show that RAP test can be proposed as an useful tool to be used by physician other than allergists when evaluating patients with rhinitis, suggesting the need of allergy testing.