MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis

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Jean Bousquet, MD, Holger J. Schünemann, MD, Peter W. Hellings, MD, Sylvie Arnavielhe, PhD, Claus Bachert, MD, Anna Bedbrook, BSc, Karl-Christian Bergmann, MD, Sinthia Bosnic-Anticevich, PhD, Jan Brozek, MD, Moises Calderon, MD, G. Walter Canonica, MD, Thomas B. Casale, MD, Niels H. Chavannes, MD, Linda Cox, MD, Henry Chrystyn, PhD, Alvaro A. Cruz, MD, Ronald Dahl, MD, Giuseppe De Carlo, MD, Pascal Demoly, MD, Phillipe Devillier, MD, Gérard Dray, PhD, Monica Fletcher, MSc, Wytske J. Fokkens, MD, Joao Fonseca, MD, Sandra N. Gonzalez-Diaz, MD, Lawrence Grouse, MD, Thomas Keil, MD, Piotr Kuna, MD, Désirée Larenas-Linnemann, MD, Karin C. Lodrup Carlsen, MD, Eli O. Meltzer, MD, Jaoquim Mullol, MD, Antonella Muraro, MD, Robert N. Naclerio, MD, Susanna Palkonen, MD, Nikolaos G. Papadopoulos, MD, Giovanni Passalacqua, MD, David Price, MD, Dermot Ryan, MD, Boleslaw Samolinski, MD, Glenis K. Scadding, MD, Aziz Sheikh, MD, Arunas Valiulis, MD, Erkka Valovirta, MD, Samantha Walker, PhD, Magnus Wickman, MD, Arzu Yorgancioglu, MD, Torsten Zuberbier, MD on behalf of the show MASK study group*

Open Access DOI: http://dx.doi.org/10.1016/j.jaci.2016.03.025

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The selection of pharmacotherapy for patients with allergic rhinitis (AR) depends on several factors, including age, prominent symptoms, symptom severity, control of AR, patient preferences, and cost. Allergen exposure and the resulting symptoms vary, and treatment adjustment is required. Clinical decision support systems (CDSSs) might be beneficial for the assessment of disease control. CDSSs should be based on the best evidence and algorithms to aid patients and health care professionals to jointly determine treatment and its step-up or step-down strategy depending on AR control.
Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR [fighting chronic diseases for active and healthy ageing]), one of the reference sites of the European Innovation Partnership on Active and Healthy Ageing, has initiated an allergy sentinel network (the MACVIA-ARIA Sentinel Network). A CDSS is currently being developed to optimize AR control. An algorithm developed by consensus is presented in this article. This algorithm should be confirmed by appropriate trials.
Abbreviations used:
AR (Allergic rhinitis), CDSS (Clinical decision support system), MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon), MASK (MACVIA-ARIA Sentinel Network), MCID (Minimal clinically important difference), QOL (Quality of life), RQLQ (Rhinoconjunctivitis Quality of Life Questionnaire),VAS (Visual analog scale)

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Working group members*: Werner Aberer, MD; Mitsuru Adachi, MD; Ioana Agache, MD; Cezmi Akdis, MD; Mubeccel Akdis, MD; Isabella Annesi-Maesano, MD; Ignacio J. Ansotegui, MD; Josep M. Anto, MD; S. Hasan Arshad, MD; Ilaria Baiardini, MD; Abay K.Baigenzhin, MD; Cristina Barbara, MD; Eric D. Bateman, MD; Bianca Beghé, MD; Elisabeth H. Bel, MD; Ali Ben Kheder, MD; Kazi S. Bennoor, MD; Michael Benson, MD; David Bernstein, MD; Bewick Michael, MD; Bieber Thomas, MD; Carsten Bindslev-Jensen, MD; Leif Bjermer, MD; Hubert Blain, MD; Attilio Boner, MD; Matteo Bonini, MD; Sergio Bonini, MD; Isabelle Bosse, MD; Jacques Bouchard, MD; Louis-Philippe Boulet, MD; Rodolphe A. Bourret, PhD; Philippe J. Bousquet, MD; Fulvio Braido, MD; Andrew H. Briggs, PhD; Christopher E. Brightling, MD; Roland Buhl, MD; Peter Burney, MD; Andrew Bush, MD; Fernando Caballero-Fonseca, MD; Davide P. Caimmi, MD; Paulo Camargos, MD; Thierry Camuzat; Kai-Hakon Carlsen, MD; Warner Carr, MD; Thomas B. Casale, MD; Alfonso Cepeda Sarabia, MD; Leda Chatzi, PhD; Yuzhi Chen, MD; Raphaël Chiron, MD; Ekaterine Chkhartishvili, MD; Alexander Chuchalin, MD; Georgio Ciprandi, MD; Ieva Cirule; Jaime Correia de Sousa, MD; David Costa, MD; George Crooks, MD; Adnan Custovic, MD; Sven-Erik Dahlen, MD; Ulf Darsow, MD; Frédéric De Blay, MD; Esteban De Manuel Keenoy, MD; Tony Dedeu, MD; Diana Deleanu, MD; Judah Denburg, MD; Alain Didier, MD; Anh-Tuan Dinh-Xuan, MD; Dejan Dokic, MD; Habib B. Douagui, MD; Ruta Dubakiene, MD; Stephen Durham, MD; Mark Dykewicz, MD; Yehia El-Gamal, MD; Regina Emuzyte, MD; Antje Fink-Wagner, PhD; Alessandro Fiocchi, MD; Francesco Forastiere, MD; Amiran Gamkrelidze, MD; Bilun Gemicioğlu, MD; Jose E. Gereda, MD; Roy Gerth van Wijk, MD; Maia Gotua, MD; Ineta Grisle, MD; M. Antonieta Guzmán, MD; Tari Haahtela, MD; Joachim Heinrich, PhD; Birthe Hellquist-Dahl, PhD; Friedrich Horak, MD; Peter H. Howarth, MD; Marc Humbert, MD; Michael Hyland, PhD; Juan-Carlos Ivancevich, MD; Edgardo J. Jares, MD; Sebastian L. Johnston, MD; Olivier Jonquet, MD; Guy Joos, MD; Ki-Suck Jung, MD; Jocelyne Just, MD; Marek Jutel, MD; Igor P. Kaidashev, MD; Musa Kaitov, MD; Omer Kalayci, MD; Fuat Kalyoncu, MD; Paul Keith, MD; Nikolai Khaltaev, MD; Jorg Kleine-Tebbe, MD; Ludger Klimek, MD; Bernard Koffi N'Goran, MD; Vitezlav Kolek, MD; Gerard H. Koppelman, MD; Marek Kowalski, MD; Inger Kull, PhD; Violeta Kvedariene, MD; Bart Lambrecht, MD; Susanne Lau, MD; Daniel Laune, PhD; Lan Le Thi Tuyet, MD; Jing Li, MD; Phillipe Lieberman, MD; Brian J. Lipworth, MD; Louis Renaud, MD; Yves Magard, MD; Antoine Magnan, MD; Bassam Mahboub, MD; Ivan Majer, MD; Mika Makela, MD; Peter J. Manning, MD; Mohamad R. Masjedi, MD; Marcus Maurer, MD; Sandra Mavale-Manuel, MD; Erik Melén, MD; Elisabete Melo-Gomes, MD; Jacques Mercier, MD; Hans Merk, MD; Neven Miculinic, MD; Florin Mihaltan, MD; Branislava Milenkovic, MD; Yousser Mohammad, MD; Mathieu Molimard, MD; Isabelle Momas, PhD; Anna Montilla-Santana, MD; Mario Morais-Almeida, MD; Ralph Mösges, MD; Rachel Nadif, PhD; Leyla Namazova-Baranova, MD; Hugo Neffen, MD; Kristof Nekam, MD; Angelos Neou, MD; Bodo Niggemann, MD; Dieudonné Nyembue, MD; Robyn O'Hehir, MD; Ken Ohta, MD; Yoshitaka Okamoto, MD; Kim Okubo, MD; Solange Ouedraogo, MD; Pier-Luigi Paggiaro, MD; Isabella Pali-Schöll, MD; Stephen Palmer, MSc; Petr Panzner, MD; Alberto Papi, MD; Hae-Sim Park, MD; Ian Pavord, MD; Ruby Pawankar, MD; Oliver Pfaar, MD; Robert Picard, PhD; Bernard Pigearias, MD; Isabelle Pin, MD; Davor Plavec, MD; Wolfgang Pohl, MD; Todor Popov, MD; Dirkje S. Postma, MD; Paul Potter, MD; Lars K. Poulsen, PhD; Klaus F. Rabe, MD; Filip Raciborski, PhD; Françoise Radier Pontal, MD; Sakari Reitamo, MD; Maria-Susana Repka-Ramirez, MD; Carlos Robalo-Cordeiro, MD; Graham Roberts, MD; Francisco Rodenas, PhD; Christine Rolland, MD; Miguel Roman Rodriguez, MD; Antonino Romano, MD; José Rosado-Pinto, MD; Nelson A. Rosario, MD; Larry Rosenwasser, MD; Menachem Rottem, MD; Mario Sanchez-Borges, MD; Joaquim Sastre-Dominguez, MD; Peter Schmid-Grendelmeier, MD; Eli Serrano, MD; F. Estelle R. Simons, MD; Juan-Carlos Sisul, MD; Ingebjorg Skrindo, MD; Henriette A. Smit, PhD; Dirceu Solé, MD; Talant Sooronbaev, MD; Otto Spranger; Rafael Stelmach, MD; Timo Strandberg, MD; Jordi Sunyer, MD; Carel Thijs, MD; Ana-Maria Todo-Bom, MD; Massimo Triggiani, MD; Rudolf Valenta, MD; Antonio L. Valero, MD; Marianne van Hage, MD; Olivier Vandenplas, MD; Giorgio Vezzani, MD; Pakit Vichyanond, MD; Giovanni Viegi, MD; Martin Wagenmann, MD; Ulrich Wahn, MD; Wang De Yun, MD; Denis Williams, PhD; John Wright, MD; Barbara P. Yawn, MD; Panayiotis Yiallouros, MD; Osman M. Yusuf, MD; Heather J. Zar, MD; Mario Zernotti, MD; Luo Zhang, MD; Nanshan Zhong, MD; Mihaela Zidarn, MD.