Content » Vol 82, Issue 4

Clinical Report

Evaluation of a Clinical Guideline for the Diagnoses of Physical and Chronic Urticaria and Angioedema

Martina M. A. Kozel, M. Chloéansari Moein, Jan R. Mekkes, Marcus M. H. M. Meinardi, Patrick M. M. Bossuyt, Jan D. Bos
DOI: 10.1080/000155502320323234


In this retrospective study, the feasibility and implementation of a clinical guideline was evaluated in 130 consecutive patients with chronic urticaria. We analysed how often a questionnaire was used, how often routine laboratory tests were performed and on what information (history-taking, detailed questionnaire, laboratory or provocation tests) the diagnosis was made. In this validation sample, the number of identified diagnoses was compared with the number of identified diagnoses of a prospective study previously performed in the same hospital. A cause was identified in 58 patients (45%): 43 of these had physical urticaria and 15 had chronic urticaria. In 50 of the 58 patients (86%) the cause was identified by history-taking and in 8 patients by additional use of the questionnaire. In 38 patients the questionnaire was not in the patient's file. In 89 of 130 patients (68%), laboratory tests were performed without a reason suggested by the patients' history. This did not reveal a cause in any patient. In general, the diagnostic guideline was followed reasonably well. In identifying a cause of urticaria, careful history-taking was important; routine laboratory tests were not helpful. A detailed questionnaire is presented in an appendix.


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