Combined symptom medication score (CSMS)

We evaluated the efficacy of SCIT by combined symptom medication score (CSMS), which was based on an equal weight of the daily symptom score (dSS) (0–3) and of the daily medication score (dMS) (0–3) in the daily total CSMS (0–6) according to AIT position paper [18]. We recorded the visual analog scale (VAS; a straight line was scaled as 0 to 10 cm, with “0” indicating “no symptoms” and “10” for “most serious symptoms” [18]): parents assessed the nasal symptoms of children in the past 3 days before injection. We converted the mean VAS score (ranged from “0” to “10”) within 180 days into symptom score (ranged from “0” to “3”). For example, if one patient’s VAS scores were “5”, “5”, “4” and “4” during the past 180 days, then the mean VAS score was (5 + 5 + 4 + 4)/4 = 4.5, the symptom score would be 4.5*3/10 = 1.35. As it was impractical to record the daily medication score (dMS) in in this open-labelled non-controlled 3-year prospective study, we calculated the total medication amounts within 180 days and converted that into the average medication dose. The medication scoring criteria were as following:“0” for “no medication”; “1” for “180-day dose of oral nonsedative H1 antihistamines (H1A) (the standard dose was 5mg loratadine daily or equal)”; “2” for “6 bottles of mometasone furoate nasal spray (180 sprays) or equal dose of other nasal steroid spray”, the total medication score was ranged from “0” to “3”. For example, if one patient used 1 bottle of mometasone furoate nasal spray and 120 mg loratadine within 180 days, then the medication score would be [(1/6)*2 + 120/ (180*5)] = 0.46. The CSMS was the sum of symptom score and medication score, ranging from “0” to “6”.