Abstract
BackgroundAn instrument to assess Allergic Rhinitis (AR) Health-Related Quality of Life (HRQL) in adult patients was developed in Spain. No validated instrument is currently cross-culturally adapted for use in daily practice to assess HRQL in AR patients in Colombia. PurposeThe aim of this study was to evaluate the measurement performance of an AR-HRQL specific questionnaire, ESPRINT-15 (Cuestionario ESPañol de Calidad de Vida en RINiTis), in Colombian adult patients with AR using the Classic Test Theory (CTT) and the Generalizability theory (G-theory) frameworks. MethodsWe conducted the cross-cultural adaptation in 2 stages. In stage 1, we evaluated comprehensibility, acceptability, and feasibility of ESPRINT-15 in healthy adults and adult patients with AR. In stage 2, we examined both reliability and validity of ESPRINT-15 scores using CTT and overall reliability applying the G-theory in adult patients with AR. ResultsFor feasibility and acceptability, all items showed a higher than 95% level of understanding, and modifications in the original questionnaire were unnecessary. Reliability and validity using CTT showed a high internal consistency (Cronbach's alpha and Mc McDonald's omega = 0.95) and test-retest reliability (scores from 0.70 to 0.76). The overall reliability score using G-theory was 0.75, and G-coefficients scores associated with internal consistency and test-retest reliability measures were 0.96 and 0.61, respectively. Validity using exploratory factor analysis (EFA) identified 2 factors instead of the original ESPRINT-15 4 domains. However, confirmatory factor analysis (CFA) showed good fit regarding the original model. ConclusionsThe proposed cross-cultural adaptation of ESPRINT-15 showed good reliability and validity measures. Additionally, it was easy to use and administer. ESPRINT-15 can be used clinically and for research in Colombian adults' patients with AR. CTT and the G-theory can be used in epidemiological studies to adapt AR-HRQL questionnaires cross-culturally in adult patients with AR.
Highlights
An instrument to assess Allergic Rhinitis (AR) Health-Related Quality of Life (HRQL)in adult patients was developed in Spain
In stage 2, we examined both reliability and validity of ESPRINT-15 scores using Classic Test Theory (CTT) and overall reliability applying the G-theory in adult patients with AR
CTT and the G-theory can be used in epidemiological studies to adapt AR-HRQL questionnaires cross-culturally in adult patients with AR
Summary
An instrument to assess Allergic Rhinitis (AR) Health-Related Quality of Life (HRQL)in adult patients was developed in Spain. The high prevalence of allergic rhinitis (AR) and its effects on health-related quality of life (HRQL) have positioned this disease as one of the main chronic respiratory diseases worldwide.[1] Globally, the prevalence of AR is around 400 million people and AR symptoms are not well recognized by patients;[2] in Colombia, the prevalence of AR symptoms ranges from 29.5% to 33.9% for the entire population, and 29.2%–32.4% in the pediatric population.[3,4] AR is associated with impaired social life, sleep, school, and work[5] and several studies have explored how AR may negatively affect sleep, concentration, performance at work, learning and school activities, social life, sexuality, and sports.[6,7,8,9,10,11,12]. HRQL data allows clinicians and patients to recognize and monitor the impact of diseases and might improve patients’ commitment to disease management.[14,15,16] AR’s significant impact on HRQL and the cost of HRQL costs suggests an important public health burden.[17,18] For instance, AR has a significant economic burden on society; in the United States, the estimated annual cost of AR is about US$2-5 billion; and in Latin-American countries, intranasal corticosteroid treatment can cost at least US$230 per annum per patient.[19,20] In consequence, the World Allergy Organization (WAO) and the Allergic Rhinitis and its Impact on Asthma (ARIA) clinical practice guidelines recommend classifying the severity of AR based on HRQL measures.[21,22,23]
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