Table 2. Summary of Guideline Key Action Statements (KAS)
Statement Action Strength
1. Patient History and
Physical Examination
Clinicians should make the clinical diagnosis
of AR when patients present with a history
and physical exam consistent with an allergic
cause and one or more of the following
symptoms: nasal congestion, runny nose, itchy
nose, or sneezing. Findings of AR consistent
with an allergic cause include, but are not
limited to, clear rhinorrhea, nasal congestion,
pale discoloration of the nasal mucosa, red
and watery eyes.
R-C
2. Allerg y Testing Clinicians should perform and interpret,
or refer to a clinician who can perform and
interpret, specific IgE (skin or blood) allerg y
testing for patients with a clinical diagnosis of
AR who do not respond to empiric treatment,
or when the diagnosis is uncertain, or when
knowledge of the specific causative allergen is
needed to target therapy.
R-B
3. Imaging Clinicians should NOT routinely perform
sinonasal imaging in patients presenting with
symptoms consistent with a diagnosis of AR.
R-C
(against)
4. Environmental Factors Clinicians may advise avoidance of known
allergens or may advise environmental controls
(i.e., removal of pets, the use of air filtration
systems, bed covers, and acaricides [chemical
agents that kill dust mites]) in AR patients
who have identified allergens that correlate
with clinical symptoms.
O-B
5. Chronic Conditions
and Comorbidities
Clinicians should assess and document in
the medical record patients with a clinical
diagnosis of AR for the presence of associated
conditions such as asthma, atopic dermatitis,
sleep-disordered breathing, conjunctivitis,
rhinosinusitis and otitis media.
R-B
6. Topical Steroids Clinicians should recommend INSs for
patients with a clinical diagnosis of AR whose
symptoms impact their quality of life.
S-A
Key Points
2