30 Chapter 2 (because of sIgE-testing and non-sedating antihistamines were used since then) [12]. We used combinations of MeSH (medical subject headings) and key words and searched unrestricted to setting but limited the search to English, German or Dutch language publications. Table 1. PICOs per sub question Element Patient (P) Intervention (I) Control (C) Outcome (O) Diagnostic accuracy Patients suspected of having allergic rhinitis in primary care sIgE-test for at least one of the allergens: Grass pollen Birch/tree pollen Herb pollen (any) House dust mite (any Dermatophagoides) Mould Cat epithelium Dog epithelium Nasal provocation of allergens Accuracy measures (sensitivity, specificity); The target condition is allergic rhinitis, measured with nasal provocation (nasal challenge) Test burden Adults/children in general Any venipuncture for diagnostic or screening purposes - Complications of testing (vasovagal reactions, pain, nerve injuries, haematoma) Management Patients with confirmed allergic rhinitis (doctor diagnosed/ sIgEtesting/ provocation) Exclusion: selfdiagnosed allergic rhinitis Allergen avoidance measures Antihistamines Nasal corticosteroids Other treatment No treatment Placebo Relief of nasal symptoms Relief of ocular symptoms Concentration Sleep problems Work/school absence Quality of life (QoL) Natural course Patients with confirmed allergic rhinitis (doctor diagnosed/ sIgEtesting/ provocation) Exclusion: selfdiagnosed allergic rhinitis - - Relief of nasal symptoms Relief of ocular symptoms Concentration Sleep problems Work/school absence Quality of life (QoL) Link between test and management Patients with a positive sIgE-test result - - Allergen avoidance Use of corticosteroids Use of antihistamines Compliance Treatment difficulties
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