Psychological Status as an Effect Modifier of the Association Between Allergy Symptoms and Allergy Testing

• Published in: Otolaryngology-head and neck surgery 2024-09, Vol.171 (3), p.894-901
• Main Authors: Kim, Minjee, Li, Anne, Prince, Anthony A., Nadkarni, Ashwini, Louisias, Margee, Corrales, Carleton Eduardo, Gilani, Sapideh, Shin, Jennifer J.
• Format: Article
• Language: English
• Subjects: allergic rhinitis; allergy; allergy testing; effect modification; objective testing; psychological status; sinonasal outcome test; subjective testing
• ISSN: 0194-5998; 1097-6817; 1097-6817
• DOI: 10.1002/ohn.846

Objective Patient‐reported outcome measures, while valuable, may not correlate with diagnostic test results. To better understand this potential discrepancy, our objective was to determine whether psychological health is an effect modifier of the association between patient‐reported allergy outcome scores and allergy test results. Study Design Prospective outcomes study. Setting Tertiary care hospital and community‐based clinic. Methods This study included 600 patients at least 18 years of age who presented for symptoms related to allergic rhinitis and completed the related sinonasal outcome test (SNOT), which includes validated nasal, allergy, and psychological domains. Stratified analyses of odds ratios and Spearman correlation coefficients were utilized to assess for effect modification by psychological status. Results Worse patient‐reported allergic rhinitis symptoms were significantly associated with positive allergy test results (odds ratio [OR] 1.69, 95% confidence interval [CI] 1.22‐2.34, P = .002) in patients with better psychological health. In contrast, there was no association in patients with worse psychological health (OR 1.06, 95% CI 0.36‐3.10, P = .92). These findings were corroborated by assessments of correlation: allergy domain scores were positively correlated with allergy testing scores (Spearman rho 0.18, 95% CI 0.10‐0.25, P