Oudkerk, M. (Martijn) (2016) Afkapwaarden voor de CARAT-vragenlijst in patiënten met astma en allergische rhinitis. thesis, Medicine.
![[img]](https://umcg.studenttheses.ub.rug.nl/style/images/fileicons/text.png) |
Text
OudkerkM.pdf Restricted to Registered users only Download (2MB) |
Abstract
Goal Allergic Rhinitis (AR) and asthma are both highly prevalent conditions which are closely related and both have a major impact on health status worldwide. Given the close relationship it has been decided to develop a questionnaire which allows simultaneous assessment of asthma and AR, the Control of Allergic Rhinitis and Asthma Test (CARAT). The aim of this study is primarily to determine cut-off values for well controlled asthma for the CARAT asthma domain. Secondarily, cut-off values for well controlled AR for the CARAT AR domain will be determined. Methods The study was conducted in collaboration with Certe, an organisation for medical advice and diagnostics. When visiting Certe, patients fill in a questionnaire containing the CARAT, Asthma Control Questionnaire (ACQ), multiple Visual Analog Scale (VAS) and items regarding Allergic Rhinitis and its Impact on Asthma (ARIA) and Global Initiative for Asthma (GINA) guidelines. Cut-off points are determined by means of Receiver Operating Characteristics (ROC) curves. The CARAT score with the largest corresponding sensitivity/specificity ratio possible will ultimately determine the cut-off value. Results will be summarized in terms of area under the curve (AUC), sensitivity, specificity, percentage correctly classified, positive and negative predictive value. Results The study included 406 patients (38% man, mean. age: 55 years, median packyears: 13, median FEV1: 95% predicted). The AUC found for the CARAT asthma domain is 0.893 [CI=0.866 – 0.919] based on the ACQ and 0.738 [CI=0.682 – 0.793] based on the GINA criteria. The optimum cut-off value found based on the ACQ is 14,5 with sensitivity 81% [CI=76 – 86] and specificity 81% [CI=74 – 86]. The optimum cut-off value based on the GINA criteria is 15,5 with sensitivity 74% [CI= 60 – 84] and specificity 63% [CI=57 – 69]. The AUC found for the CARAT AR domain is 0.848 [CI=0.802 – 0.894] based on VAS and 0.724 [CI=0.652 – 0.796] based on the ARIA criteria. The cut-off value found based on the VAS is 8,5 with sensitivity 61% [CI=56 – 66] and specificity 93% [CI=82 – 98]. The optimum cut-off value based on the ARIA criteria is 6,5 with sensitivity 68% [CI=59 – 77] and specificity 72% [CI=59 – 82]. Conclusion CARAT scores within the asthma domain greater than or equal to 15 or 16, depending on the preferred golden standard, seem to identify patients met well-controlled asthma. In addition, CARAT scores within the AR domain greater than or equal to 7 or 9 identify patients with well-controlled AR. Cut-off values 15 and 7 have the slight preference. Starting from these scores as cut-off values, with AUC 0.887 and 0.852, the CARAT proves to be an accurate instrument for distinguishing patients with, respectively, well- and not well-controlled asthma and AR. The determination of the cut-off values of the CARAT is the last step in the development of the questionnaire and the CARAT now could be used in practice in the Netherlands.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisors: and Jong, Dr. C. de and Flokstra-de Blok, Dr. B. and Afdeling Huisartsgeneeskunde and Universitair Medisch Centrum Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:42 |
| Last Modified: | 25 Jun 2020 10:42 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/317 |
Actions (login required)
 |
View Item |