Article open access publication

MACVIA clinical decision algorithm in adolescents and adults with allergic rhinitis

Journal of Allergy and Clinical Immunology, Elsevier, ISSN 0091-6749

Volume 138, 2, 2016

DOI:10.1016/j.jaci.2016.03.025, Dimensions: pub.1037553088, PMID: 27260321,


Bousquet, Jean * (1) (2) (3)
Cox, Linda (14)
Demoly, Pascal (2) (19)
Yorgancioglu, Arzu (45) (46)

* Corresponding author



  1. (1) French Institute of Health and Medical Research, grid.7429.8
  2. (2) University Hospital of Montpellier, grid.157868.5
  3. (3) MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
  4. (4) McMaster University, grid.25073.33
  5. (5) KU Leuven, grid.5596.f
  6. (6) Kyomed, Montpellier, France
  7. (7) Ghent University Hospital, grid.410566.0
  8. (8) Charité, grid.6363.0
  9. (9) Woolcock Institute of Medical Research, grid.417229.b
  10. (10) Imperial College London, grid.7445.2
  11. (11) Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
  12. (12) University of South Florida, grid.170693.a
  13. (13) Leiden University Medical Center, grid.10419.3d
  14. (14) Nova Southeastern University, grid.261241.2
  15. (15) RiRL, Cambridge, United Kingdom
  16. (16) Federal University of Bahia, grid.8399.b
  17. (17) Odense University Hospital, grid.7143.1, Southern Denmark Region
  18. (18) European Federation of Allergy and Airways Diseases Patients Associations, grid.434606.3
  19. (19) EPAR U707 INSERM, Paris and EPAR UMR-S UPMC, Paris VI, Paris, France
  20. (20) Hôpital Foch, grid.414106.6
  21. (21) École des Mines d'Alès, grid.424464.4
  22. (22) Education for Health, Warwick, United Kingdom
  23. (23) Academic Medical Center, grid.5650.6
  24. (24) University of Porto, grid.5808.5
  25. (25) Universidad Autónoma de Nuevo León, grid.411455.0
  26. (26) University of Washington, grid.34477.33
  27. (27) University of Würzburg, grid.8379.5
  28. (28) Medical University of Lodz, grid.8267.b
  29. (29) Hospital Médica Sur, grid.414741.3
  30. (30) Oslo University Hospital, grid.55325.34
  31. (31) Allergy and Asthma Medical Group and Research Center, grid.413627.5
  32. (32) Unitat de Rinologia i Clínica de l'Olfacte, Servei d'ORL, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
  33. (33) Azienda Ospedaliera di Padova, grid.411474.3
  34. (34) Section of Otolaryngology-Head and Neck Surgery, University of Chicago Medical Center and Pritzker School of Medicine, University of Chicago, Chicago, Ill
  35. (35) National and Kapodistrian University of Athens, grid.5216.0
  36. (36) University of Aberdeen, grid.7107.1
  37. (37) University of Edinburgh, grid.4305.2
  38. (38) Medical University of Warsaw, grid.13339.3b
  39. (39) University College London, grid.83440.3b
  40. (40) University Hospital of Lausanne, grid.8515.9
  41. (41) Vilnius University, grid.6441.7
  42. (42) University of Turku, grid.1374.1
  43. (43) Asthma UK, grid.453156.0
  44. (44) Sachs' Children and Youth Hospital, grid.416452.0
  45. (45) Celal Bayar University, grid.411688.2
  46. (46) Department of Pulmonology, Celal Bayar University Manisa, Turkey, and GARD Executive Committee, Manisa, Turkey
  47. (47) Helsinki University Central Hospital, grid.15485.3d


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.


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