The monthly hay fever survey in Sam: what it asks, how it is scored and how to read your result

Once a month, the hay fever survey asks how much your allergy symptoms bothered you in the past week, on a scale from 0 to 10. You can note it on paper or answer it in the hay fever diary in Sam, which adds the trend to the doctor report PDF. This guide explains what the six questions ask, how the score is worked out and what it can tell you.

The survey is Sam's own. It follows the visual analogue scale (VAS) method used in allergy research and in the ARIA guideline. It is not an independently validated questionnaire. Where Sam borrows a number from a study, this article names the study.

What does the hay fever survey in Sam ask?

All six questions look back over the past 7 days. The first five are ratings from 0 to 10. The sixth is a count of days. In plain words, they cover:

• How much your allergy symptoms bothered you overall.
• Your nose: blocked or runny, sneezing.
• Your eyes: itching, watering, redness.
• Your chest or asthma symptoms, only if you have asthma. Otherwise you leave it at 0.
• How much the symptoms got in the way of sleep or daily activities.
• On how many of the 7 days you used rescue or symptom medication, such as an antihistamine or a nasal spray.

Each rating has words at both ends, for example "not at all bothersome" and "extremely bothersome". Sam shows the scale as eleven boxes from 0 to 10, not as a continuous line. Strictly speaking, that makes it a numeric rating in the style of a VAS.

The survey does not ask about pollen. In the diary, Sam adds the measured pollen and air quality to new entries for today. That needs your approximate location.

Is the hay fever VAS a validated questionnaire?

No. The six questions were written for Sam, and no study has tested this survey as a whole. What has been studied is the method behind it.

A visual analogue scale asks you to place your symptoms between two ends, classically on a 10 cm line. One study looked at 3,052 people with allergic rhinitis in primary care. Their VAS ratings matched the ARIA severity grades well (Bousquet 2007). A position paper of the German allergy societies AeDA and DGAKI calls the VAS well suited for everyday practice. By that paper, it can also follow the course of a chronic disease such as allergic rhinitis (Klimek 2017).

The ARIA guideline 2019 for the German health system builds its step-up scheme for medication on VAS ratings. A smartphone version of the scale was tested in 14,612 uses across 15 countries and found reliable at population level (Caimmi 2017). That study tested a research app, not Sam.

So Sam uses a studied method with its own questions. Read the score as your personal record, not as a test result.

Why does only the first question become your score?

Your score is your answer to question 1 alone, the overall rating. Nothing is added up. A score of 6 means you rated your overall symptoms a 6.

The reason is simple. The published meaning of a VAS cut-off belongs to the overall rating. Adding nose, eyes, chest and sleep to it would create a new number that no study has looked at.

The other five answers are still kept. In Sam you can open any past survey and see all six answers. That helps when you talk a season through with your doctor. Were the eyes the main problem, or the nights? The article on a blocked nose at night covers the sleep side.

What do mild and moderate to severe mean?

Next to the number, Sam shows one of two words:

The cut at 5 comes from Bousquet 2007. In that study, a VAS under 5 cm went with mild rhinitis by ARIA grades. A VAS over 6 cm went with moderate to severe rhinitis. Sam uses one cut at 5, so a 5 already counts as moderate to severe. In most studies, says the German position paper, 50 on a 100 mm line marks moderate to severe allergic rhinitis.

The two words describe how strong your symptoms felt in the past 7 days. They say nothing about the allergen, and they are not a diagnosis. The doctor report states it too: the bands are descriptive.

The paper also lists the MACVIA-ARIA cut-offs for disease control. They are under 20, 20 to 50 and over 50 on the 100 mm line. Sam does not use those control bands. What a value means for your medication is a question for your doctor.

When does a change from one month to the next count as notable?

After each survey, Sam compares your overall rating with the one before. If you crossed from one band into the other, the result screen says so. If the score moved by 2 points or more, Sam calls the change notable. Smaller moves show up as a higher, lower or steady score.

The 2 points come from Demoly 2013. That study followed 990 patients in primary care. A change of 23 mm on the 100 mm line matched a change of 0.5 points on the RQLQ, a quality of life questionnaire for rhinitis. Sam rounds that to 2 on its 0 to 10 scale. Whether the study value carries over to a monthly rating with eleven boxes has not been tested. That is why Sam says notable, not clinically meaningful.

One survey covers one week, and a single week can be untypical. A pattern over several months says more than one jump. To compare whole seasons, see what to do when hay fever medicine seems to stop working.

When does Sam ask, and where do you see the result?

Sam asks for the first time when you start the hay fever program. A program in Sam is its own diary with a doctor report and a monthly questionnaire. After that, the survey is due every 30 days. A reminder comes when it is due, and one follow-up three days later if you have not answered. You can also answer earlier. An extra survey does not shift the schedule.

Hay fever is seasonal, so the reminder can pause. That only happens when you share your location and the measured pollen is below moderate. You also need to have logged symptom days before, but none in the last three weeks. The survey stays open during the pause.

Your result shows up in three places:

• On the survey card in the hay fever diary, with the latest value, its band and the change since your first survey.
• In the survey history, with a trend chart and every past survey.
• In the doctor report, a PDF for 1, 3, 6 or 12 months or the whole record.

The report shows the latest value with its band, and a trend chart from two surveys on. It carries only the overall score. The other five answers stay in Sam.

How do you get a fair reading each month?

A few habits keep your numbers comparable.

• Think only of the past 7 days, not of the whole season.
• Answer on the day the survey is due, not a week later from memory.
• Keep the same picture of 10 in mind each time: extremely bothersome.
• Leave the asthma question at 0 if you do not have asthma. It never changes the score.
• Log bad days in the diary as they happen. Diary entries carry the day's pollen, the survey does not.

If you also live with asthma, the asthma program has its own monthly check. How it works is in the guide to GINA asthma symptom control.

Keep your monthly hay fever score in Sam and bring the trend

Your monthly rating becomes a trend you can show at the appointment. It comes from the hay fever program with its diary and doctor report.

• Instead of a number on a scrap of paper: the doctor report PDF shows your overall score over the months.
• Instead of remembering it yourself: Sam reminds you when the next survey is due.
• Instead of guessing the pollen: new diary entries for today get measured pollen and air quality, with your location shared.
• Instead of a single number: all six answers stay in Sam for the talk with your doctor.

Sam keeps what you enter. The program starts once you confirm that a doctor has found hay fever.

Try Sam for free

Sam is a wellness companion, not a medical device. The app does not diagnose, treat, cure or prevent any disease or health condition. Always consult qualified professionals for medical decisions.

Related reading

• Hay fever ruins every summer: when to see an allergist
• Allergen immunotherapy: three years in a diary

Sources

Updated: October 2026

• Bousquet PJ, Combescure C, Neukirch F, Klossek JM, Mechin H, Daures JP, Bousquet J: Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines. Allergy 2007;62(4):367-372. doi:10.1111/j.1398-9995.2006.01276.x (PMID 17362246).
• Demoly P, Bousquet PJ, Mesbah K, Bousquet J, Devillier P: Visual analogue scale in patients treated for allergic rhinitis: an observational prospective study in primary care. Clin Exp Allergy 2013;43(8):881-888. doi:10.1111/cea.12121 (PMID 23889242).
• Klimek L, Bergmann KC, Biedermann T et al.: Visual analogue scales (VAS): Measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care. Position paper of AeDA and DGAKI (ENT section) with DGHNO-KHC. Allergo J Int 2017;26(1):16-24. PMC5288410 (CC BY 4.0).
• Klimek L, Bachert C, Pfaar O et al.: ARIA guideline 2019: treatment of allergic rhinitis in the German health system. Allergologie Select 2019;3(1):22-50, reprint of Allergo J Int 2019;28:255-276. PMC7066682.
• Caimmi D, Baiz N, Tanno LK et al.: Validation of the MASK-rhinitis visual analogue scale on smartphone screens to assess allergic rhinitis control. Clin Exp Allergy 2017;47(12):1526-1533. doi:10.1111/cea.13025 (PMID 28886234).