Applying GRADE for diagnosis 35 2 Figure 1b. Literature search and selection of the sub-questions (management, natural course) Medline search n = 182 Embase search n = 217 Total number of records n = 399 Title and abstract screening Records excluded n = 395 Full-text articles Assessed for eli gi bili ty n = 4 Full-text articles exluded with reasons n = 3. - 2nd publication about 1 review (n=1) - no systematic review (n=2) Included in evidence synthesis n = 1 Avoidance Antihistamines Medline search n = 429 Embase search n = 50 Total number of records n = 479 Title and abstract screening Records excluded n = 438 Full-text articles Assessed for eli gibili ty n = 41 Full-text articles exluded with reasons n = 26. - no systematic review of adequate quality (n=20) - not about allergic rhinitis (n=1) - no adequate comparison group (n=1) - not about effectiveness antihistaminics (n=3) - no monotherapy with antihistaminics (n=1) Eligible n = 15 Corticosteroids Medline search n = 173 Embase search n = 38 Total number of records n = 211 Title and abstract screening Records excluded n = 184 Full-text articles Assessed for eli gi bili ty n = 27 Full-text articles exluded with reasons n = 15. - no systematic review of adequate quality (n=13) - no selected outcome measures (n=1) - no group effect (n=1) Eligible n = 12 Natural course Medline search n = 201 Embase search n = 130 Total number of records n = 331 Title and abstract screening Records excluded n = 311 Full-text articles Assessed for eli gibili ty n = 20 Full-text articles exluded with reasons n = 13. - no selected outcome measures (n=7) - no followup of patients with allergic rhinitis (n=4) - no prospective design (n=1) - all patients on medication (n=1) Included in evidence synthesis n = 7 Management Selection of systematic reviews that compared antihistamines to placebo of adequate quality Included in evidence synthesis n = 2 Selection of systematic reviews that compared corticosteroids to placebo of adequate quality Included in evidence synthesis n = 3 Identification Screening Eligib ili ty Included
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