Control of allergic rhinitis and asthma test--a formal approach to the development of a measuring tool

Luis Nogueira-Silva, Sonia V Martins, Ricardo Cruz-Correia, Luis F Azevedo, Mario Morais-Almeida, António Bugalho-Almeida, Marianela Vaz, Altamiro Costa-Pereira, Joao A Fonseca, Luis Nogueira-Silva, Sonia V Martins, Ricardo Cruz-Correia, Luis F Azevedo, Mario Morais-Almeida, António Bugalho-Almeida, Marianela Vaz, Altamiro Costa-Pereira, Joao A Fonseca

Abstract

Background: The concurrent management of allergic rhinitis and asthma (ARA) has been recommended by Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines. However, a tool capable of assessing simultaneously the control of upper and lower airways diseases is lacking.

Aim: To describe the studies conducted to design the control of ARA test (CARAT) questionnaire.

Methods: We performed a literature review to generate a list of potentially important items for the assessment of control of ARA. A formal consensus development process, that used an innovative web-based application, was designed - 111 experts in ARA and 60 patients participated. At the final consensus meeting, 25 primary and secondary care physicians formulated the questions and response options. A qualitative feasibility study (n = 31 patients) was conducted to evaluate the comprehensibility of the questionnaire while testing two different designs.

Results: Thirty-four potentially important items were identified. All the steps of the consensus process were completed in 2.5 months. The opinions of experts and patients lead to the formulation of 17 questions. At the feasibility study the instructions and wording problems were corrected and a semi-tabular format was chosen.

Conclusion: A tool to measure the control of allergic rhinitis and asthma was developed using a comprehensive set of methodological steps ensuring the design quality and the face and content validity. Additional validation studies to assess the psychometric properties of the questionnaire have started.

Figures

Figure 1
Figure 1
Item generation flowchart. From the questions retrieved from published questionnaires, the potentially important items were identified. *four were asthma control questionnaires; none were allergic rhinitis control questionnaires; 6 assessed ARA concurrently but none its control.
Figure 2
Figure 2
Sorted items. The 34 items from the item generation phase are presented, ranked by their score (inverse of the proportion of participants who chose the item, multiplied by the sum of its rankings). The shortlist (filled bars) included the highest scored items and the only item suggested by the participants ("Work/school absenteeism").

References

    1. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, Zuberbier T, Baena-Cagnani CE, Canonica GW, Van Weel C, Agache , Aït-Khaled N, Bachert C, Blaiss MS, Bonini S, Boulet L-P, Bousquet P-J, Camargos P, Carlsen K-H, Chen Y, Custovic A, Dahl R, Demoly P, Douagui H, Durham SR, Van Wijk RG, Kalayci O, Kaliner MA, Kim Y-Y, Kowalski ML, Kuna P, Le LTT, Lemiere C, Li J, Lockey RF, Mavale-Manuel S, Meltzer EO, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Ouedraogo S, Palkonen S, Papadopoulos N, Passalacqua G, Pawankar R, Popov TA, Rabe KF, Rosado-Pinto J, Scadding GK, Simons FER, Toskala E, Valovirta E, Van Cauwenberge P, Wang D-Y, Wickman M, Yawn BP, Yorgancioglu A, Yusuf OM, Zar H, Annesi-Maesano I, Bateman ED, Kheder AB, Boakye DA, Bouchard J, Burney P, Busse WW, Chan-Yeung M, Chavannes NH, Chuchalin A, Dolen WK, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Keith PK, Kemp JP, Klossek J-M, Larenas-Linnemann D, Lipworth B, Malo J-L, Marshall GD, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Potter P, Price D, Stoloff SW, Vandenplas O, Viegi G, Williams D. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA2LEN and AllerGen) Allergy: European Journal of Allergy and Clinical Immunology. 2008;63(SUPPL 86):8–160. doi: 10.1111/j.1398-9995.2007.01620.x.
    1. Bousquet J, Bousquet PJ, Godard P, Daures JP. The public health implications of asthma. Bulletin of the World Health Organization. 2005;83(7):548–554.
    1. Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2007. 2007.
    1. Braunstahl GJ, Fokkens W. Nasal involvement in allergic asthma. Allergy: European Journal of Allergy and Clinical Immunology. 2003;58(12):1235–1243. doi: 10.1046/j.0105-4538.2003.00354.x.
    1. Juniper EF, Guyatt GH, Epstein RS, Ferrie PJ, Jaeschke R, Hiller TK. Evaluation of impairment of health related quality of life in asthma: Development of a questionnaire for use in clinical trials. Thorax. 1992;47(2):76–83. doi: 10.1136/thx.47.2.76.
    1. Marks GB, Dunn SM, Woolcock AJ. An evaluation of an asthma quality of life questionnaire as a measure of change in adults with asthma. Journal of Clinical Epidemiology. 1993;46(10):1103–1111. doi: 10.1016/0895-4356(93)90109-E.
    1. Kilpelaïnen M, Terho EO, Helenius H, Koskenvuo M. Validation of a new questionnaire on asthma, allergic rhinitis, and conjunctivitis in young adults. Allergy: European Journal of Allergy and Clinical Immunology. 2001;56(5):377–384. doi: 10.1034/j.1398-9995.2001.056005377.x.
    1. Revicki DA, Leidy NK, Brennan-Diemer F, Sorensen S, Togias A. Integrating patient preferences into health outcomes assessment: The multiattribute asthma symptom utility index. Chest. 1998;114(4):998–1007. doi: 10.1378/chest.114.4.998.
    1. Fonseca JA, Delgado L, Costa-Pereira A, Tavares C, Moreira A, Morete A, de Oliveira F, Rodrigues J, Vaz M. Evaluation of the Asthma Life Quality test for the screening and severity assessment of asthma. Allergy: European Journal of Allergy and Clinical Immunology. 2004;59(11):1198–1204. doi: 10.1111/j.1398-9995.2004.00515.x.
    1. Boulet LP, Boulet V, Milot J. How should we quantify asthma control? A proposal. Chest. 2002;122(6):2217–2223. doi: 10.1378/chest.122.6.2217.
    1. Juniper EF, O'Byrne PM, Guyatt GH, Ferrie PJ, King DR. Development and validation of a questionnaire to measure asthma control. European Respiratory Journal. 1999;14(4):902–907. doi: 10.1034/j.1399-3003.1999.14d29.x.
    1. Nathan RA, Sorkness CA, Kosinski M, Schatz M, Li JT, Marcus P, Murray JJ, Pendergraft TB. Development of the Asthma Control Test: A survey for assessing asthma control. Journal of Allergy and Clinical Immunology. 2004;113(1):59–65. doi: 10.1016/j.jaci.2003.09.008.
    1. Vollmer WM, Markson LE, O'Connor E, Sanocki LL, Fitterman L, Berger M, Buist AS. Association of asthma control with health care utilization and quality of life. Am J Respir Crit Care Med . 1999;160(5 Pt 1):1647–1652.
    1. Juniper EF, Guyatt GH. Development and testing of a new measure of health status for clinical trials in rhinoconjunctivitis. Clinical and Experimental Allergy. 1991;21(1):77–83. doi: 10.1111/j.1365-2222.1991.tb00807.x.
    1. Baiardini I, Pasquali M, Giardini A, Specchia C, Passalacqua G, Venturi S, Braido F, Bonini S, Majani G, Canonica GW. Rhinasthma: A new specific QoL questionnaire for patients with rhinitis and asthma. Allergy: European Journal of Allergy and Clinical Immunology. 2003;58(4):289–294. doi: 10.1034/j.1398-9995.2003.00079.x.
    1. Bousquet PJ, Combescure C, Neukirch F, Klossek JM, Méchin H, Daures JP, Bousquet J. Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines. Allergy: European Journal of Allergy and Clinical Immunology. 2007;62(4):367–372. doi: 10.1111/j.1398-9995.2006.01276.x.
    1. Control of Allergic Rhinitis and Asthma Test" (CARAT) project
    1. Van Oene CM, Van Reij EJF, Sprangers MAG, Fokkens WJ. Quality-assessment of disease-specific quality of life questionnaires for rhinitis and rhinosinusitis: A systematic review. Allergy: European Journal of Allergy and Clinical Immunology. 2007;62(12):1359–1371. doi: 10.1111/j.1398-9995.2007.01482.x.
    1. Revicki D, Weiss KB. Clinical assessment of asthma symptom control: Review of current assessment instruments. Journal of Asthma. 2006;43(7):481–487. doi: 10.1080/02770900600619618.
    1. Scopus database
    1. Murphy M, Black N, Lamping D, McKee C, Sanderson C, Askham J, Marteau T. Consensus development methods, and their use in clinical guideline development. Health Technol Assess. 1998;2(3):1–88.

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