Symptom scores as measures of the severity of rhinitis

Methodological aspects of subjective symptom ratings were investigated in 103 symptomatic rhinitis patients. The patient's own overall rating registered on a visual analogue scale was compared with a summed symptom score calculated from ratings of sneezing, rhinorrhea and congestion. A significant correlation, but not complete correspondence, was found in patients with untreated rhinitis during the birch pollen season and after challenges with birch pollen or histamine. Comparisons between the overall rating and scores for individual symptoms gave lower degrees of correlation or non-significant correlations. When twenty-five patients were treated with an intranasal corticosteroid during the pollen season, both the overall rating and the summed symptom score decreased significantly. The changes in the two ratings for each patient showed a moderate correlation. The patients' ratings of rhinorrhea correlated with an approximate measure of the volume of secretion after pollen challenge but not during the pollen season or after histamine challenge. It is recommended on the basis of these findings that, for measuring the severity of rhinitis, scores indicating the course of individual symptoms should not be combined into a summed score, but that the patient's overall rating of the condition should be used. Scores for individual symptoms can be used to draw more detailed conclusions about nasal pathophysiological features and about qualitative disimilarities between different modes of therapy.