D3.31 - Real-world Practices in the Diagnosis and Evaluation of Allergic Rhinitis among Korean Specialists

Diagnostic and evaluative approaches for allergic rhinitis (AR) can differ substantially among medical specialties. This study aimed to explore current real-world practices among Korean physicians in the diagnosis and evaluation of AR.

A multidisciplinary taskforce from the Rhinitis Working Group of the Korean Academy of Asthma, Allergy and Clinical Immunology developed and refined a detailed questionnaire based on expert consensus. The final version included items on clinical evaluation, diagnostic tools, and perceived barriers, using a 5-point Likert scale. 

A total of 77 specialists completed the survey, including 31 internists, 24 otorhinolaryngologists, and 22 pediatricians. Specific IgE testing was more frequently utilized than skin prick testing for allergen sensitization across all specialties. Rhinoscopy was performed routinely by all otorhinolaryngologists, but far less commonly by pediatricians (47.7%) and internists (12.9%). The use of ostiomeatal unit CT in more than half of patients was reported by 20.8% of otorhinolaryngologists, 3.2% of internists, and none of the pediatricians. Symptom scoring tools such as the visual analog scale, total nasal symptom score, and quality of life questionnaires were infrequently used, with time constraints and reliance on clinical history cited as key barriers. Evaluation of comorbidities varied significantly; pediatricians more often assessed mouth breathing and obstructive sleep apnea than internists or otorhinolaryngologists. Regarding pollen-food allergy syndrome, 47.7% of pediatricians and 35.5% of internists screened more than half of their seasonal AR patients, compared to only 8.3% of otorhinolaryngologists. 

These findings highlight significant inter-specialty variations in the diagnostic and evaluative strategies for AR in Korea. While symptom-based approaches remain standard, objective tools and structured assessments are underutilized. This underscores the need for multidisciplinary consensus guidelines to promote standardized, evidence-based practice in AR care.