The Control of Allergic Rhinitis and Asthma Test: validation of the Dutch version

Leeuw, S. van der (Sander) (2013) The Control of Allergic Rhinitis and Asthma Test: validation of the Dutch version. thesis, Medicine.

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Abstract

Background: Simultaneous treatment of allergic rhinitis and asthma has been recommended by the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines. The Portuguese Control of Allergic Rhinitis and Asthma Test (CARAT) was therefore developed to monitor the control of both asthma and allergic rhinitis in primary and secondary care. This questionnaire was translated to Dutch. Objectives: The primary objectives of this study were to evaluate the internal consistency, construct validity and longitudinal validity of the Dutch CARAT. Furthermore, test-retest reliability and Minimal Clinically Important Difference (MCID) were investigated. Methods: The Dutch CARAT study is a longitudinal study consisting of three measurements with one month intervals. 176 patients diagnosed with asthma and/or rhinitis from three primary care practices and three secondary care centers were approached. Cronbach’s alpha was used to evaluate internal consistency. CARAT scores (ranging from 0-30) were compared to the Asthma Control Questionnaire (ACQ) and VAS scores concerning airway symptoms. Spearman’s correlation coefficients were used to determine construct and longitudinal validity. For the longitudinal analysis delta scores (t2-t1 and t3-t2) of the CARAT, ACQ and VAS were used. Test-retest reliability and Minimal Clinically Important Difference (MCID) were evaluated using Global Rating of Change (GRC) scores to define categories according to change in symptoms over time. Results: A total of 93 patients were included. The mean CARAT score for all patients was 19.4 (SD 6.80). Cronbach’s alpha for the CARAT was 0.82. Correlation coefficients between CARAT and the ACQ and VAS questions ranged from 0.64(p<0.01) to 0.76(p<0.01). Longitudinally, correlation coefficients between delta CARAT scores and delta ACQ and VAS ranged from 0.41 to 0.67 (p<0.01) for both one month intervals. Calculations for test-retest reliability showed correlation coefficients of 0.74(p<0.01) and 0.78(p<0.01) between CARAT scores of patients in the ‘no change’-category according to GRC. The MCID for the CARAT was 3.50. Conclusion: The Dutch CARAT has high internal consistency and good construct validity and is therefore comparable to findings according to the Portuguese CARAT. The Dutch CARAT also proves to be longitudinally valid, with good test-retest reliability. The determination of MCID is highly beneficial for interpreting CARAT scores. Therefore, the CARAT is a valid and reliable tool for use in clinical research and practice to monitor asthma and allergic rhinitis symptoms simultaneously.

Item Type:	Thesis (Thesis)
Supervisor name:	Molen, Prof. T. van der and Flokstra, Dr. B.M.J.
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/349

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