Applying GRADE for diagnosis 83 2 Number at follow-up: 108 patients, 64% female, age range 59-69 yrs (mean 62.1). Outcome measures (nasal / ocular symptoms, concentration, sleep problems, absenteeism from school / work, quality of life) Nasal symptoms on VAS scale; diagnosis: mean 68.0, follow-up: 53.5 (p<0.0001). Complete remission: 27/118: 22.9%; less severe symptoms: 28/118: 23.7%; no change: 51/118: 42.2%; more severe symptoms: 12/118: 10.2%. Average follow-up 16.3 yrs (range 14-19) Risk of bias (tailormade criteria) Primary Was there a representative sample of patient (who were at a similar, identifiable, common, and possible early point in the course of the disease)? Yes/no/unclear Was follow-up sufficiently long and complete? Yes/no/unclear Secondary Were objective and unbiased outcome criteria used? Yes/no/unclear Were all characteristics of patients known or suspected to affect the outcome recorded (e.g. comorbidity) Yes/no/unclear Was there adjustment for important prognostic factors (e.g. information about treatment)? Yes/no/unclear Greisner, 1998 [11] Author Greisner Year of publication 1998 Journal Allergy and Asthma Proceedings Study design Follow-up study Setting Population based, USA Study population Baseline 1962/1963: 1836 college freshmen, 30% female. Number at follow-up: 1021 persons (56%), 31% female, mean age 40 yrs (range: 38-64y; 97% 4042 yrs); at follow-up: 306 individuals with hay fever from a sample of 738 that had previously been skin tested Outcome measures (nasal / ocular symptoms, concentration, sleep problems, absenteeism from school / work, quality of life) Symptoms, at follow-up: 22.9% symptom free, 32.0% better (but not symptom free), unchanged 33.3%, worsened:9.2%, unknown: 2.6%. Follow-up: 23 years Risk of bias (tailormade criteria) Primary Was there a representative sample of patient (who were at a similar, identifiable, common, and possible early point in the course of the disease)? Yes/no/unclear Was follow-up sufficiently long and complete? Yes/no/unclear Secondary Were objective and unbiased outcome criteria used? Yes/no/unclear Were all characteristics of patients known or suspected to affect the outcome recorded (e.g. comorbidity) Yes/no/unclear Was there adjustment for important prognostic factors (e.g. information about treatment)? Yes/no/unclear Kellberger, 2012 [12] Author Kellberger Year of publication 2012 Journal Journal of Allergy and Clinical Immunology Study design Prospective cohort study
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