Table 1 Items included in the questionnaire about “General approach to polysensitized subjects” (1A) and results (1B)
1A) | 1B) | ||||
|---|---|---|---|---|---|
Items | Mean | Median | % Panellists against | IQ | Result |
Diagnostic approach to a patient with suspected respiratory allergy | |||||
1- Skin-tests are sufficient for the correct aetiologic diagnosis of patients with respiratory allergy | 3.08 | 3 | 32.26 | 2 | D |
2- The size of the wheal is useful in the clinically relevant allergen identification | 3.75 | 3 | 35 | 2.5 | NC |
3- A positive skin-test indicates the clinical relevance of the allergenic source | 2.11 | 2 | 9.68 | 1.5 | D |
4- The specific IgE determination and quantification help us to establish the clinical relevance of an allergenic source | 6.22 | 7 | 28.33 | 1 | A |
5- Molecular diagnosis serves to differentiate primary sensitisation from cross-reactivity | 7.84 | 8 | 6.45 | 1 | A |
6- In molecular diagnostic tests, a cut-off that allows us to differentiate relevant allergens does not exist | 6.97 | 7 | 27.42 | 2 | A |
7- The patient diagnostic approach must be similar, independent of whether respiratory symptoms are persistent or intermittent | 6.92 | 8 | 25.81 | 3 | A |
8- The directed medical history and symptoms-exposure schedule allows us to identify the responsible allergenic source of the patient’s clinic in some cases | 7 | 7 | 11.67 | 0 | A |
9- Organ-specific provocation tests are not useful in daily clinical practice due to their difficult interpretation and because they are time consuming | 7.1 | 8 | 16.67 | 1 | A |
10a- The polysensitised patient is one who presents sensitisation to various allergenic sources | 7.47 | 8 | 11.67 | 2 | A |
10b- The polyallergic patient is one who presents sensitisation with demonstrated clinical relevance | 7.90 | 8 | 8.33 | 1 | A |
11- The aerobiological information should include the allergenic load in the environment | 7.42 | 8 | 14.52 | 1 | A |
Determinant criteria in immunotherapy prescription | |||||
12- Before immunotherapy prescription to a polysensitised patient, an organ-specific provocation with all suspected relevant allergens must be conducted | 2.4 | 2 | 17.74 | 2 | D |
13- Assessment of the intensity of symptoms and medication consumption in relation to allergenic exposure should be habitual practice in immunotherapy prescription | 8.23 | 8 | 1.61 | 1 | A |
14- Immunotherapy should only be used based on clinical studies that follow current guidelines | 6.92 | 7.5 | 29.03 | 2.5 | A |
15-Immunotherapy prescription is advised only if relevant allergen sources are identified | 7.22 | 7 | 6.67 | 1 | A |
Immunotherapy composition | |||||
16- Enzymatic activity (proteolysis) over others should not be used | 7.6 | 8 | 14.52 | 2 | A |
17- It is acceptable to include up to two or three allergens in one vaccine if their relevance is identified | 6.28 | 7 | 28.33 | 2 | A |
18- Immunotherapy should include all relevant allergenic sources | 3.63 | 3 | 25 | 1 | D |
19- Safety studies of a given extract are applicable to all extracts from identical allergenic sources | 2.31 | 2 | 14.52 | 2 | D |
20- Efficacy studies of a given extract are assimilable to all extracts from identical allergenic sources | 2.55 | 2 | 17.74 | 2 | D |
21- The extract mixture has a nonspecific positive therapeutic effect despite dosage reduction of included allergens | 4.27 | 5 | 46.67 | 2 | NC |
22- If mixtures of several allergenic sources are used in immunotherapy, it is necessary to ensure the effective concentration of each one in the final composition | 7.89 | 8 | 6.45 | 2 | A |
24- The dose–response studies are conducted with vaccines from one allergenic source so the results cannot be extrapolated to those of mixtures | 7.16 | 8 | 22.58 | 1.5 | A |