Validating app and 1-week version of the ´control of allergic rhinitis and asthma test´ (CARAT)

Abstract

The Control of allergic rhinitis and asthma test (CARAT) has been designed to assess control of both asthma and allergic rhinitis (AR), covering a 4 week period, using paper-and-pencil (4wCARAT). It met al COSMIN criteria for patient reported outcomes. The aim is validation of the 1-week digital version and paper version (1wCARATapp and 1wCARAT. Asthma patients completed the 1wCARAT and 1wCARATapp each week for 1 month. At baseline the Asthma Control Questionnaire (ACQ), Visual Analog Scale (VAS), Global Initiative for Asthma (GINA) and the Allergic Rhinitis And Its Impact On Asthma (ARIA) were completed . At final visit the 4wCARAT was completed. Internal consistency was analysed with Cronbach's alfa, test-retest reliability with Spearman's correlation, relation between 4wCARAT and 1wCARAT and 1wCARAT and 1wCARATapp via Wilcoxon-Signed-Rank. The construct validity (using VAS general complaints for CARAT total score; ACQ and GINA for CARAT asthma subscale; VAS nasal complaints and ARIA for CARAT AR subscale) was calculated with Spearman correlation and Students T-test. Data from 109 asthma patients (39% men, mean 53 yrs) showed no significant differences between 1wCARAT and 4wCARAT. 1wCARAT featured Cronbach's alpha >.79 for all (sub)scales. Correlations between 1wCARAT and ACQ/VAS/GINA were significant (p>.001; .57≥r≤.71), as was the difference in CARAT AR score between ARIA mild vs medium/severe AR (p=0.01). Test-retest reliability between measuring moments was significant (p<0.001; .72≥r ≤.91;) for 1wCARAT and 1wCARATapp. No significant differences were found between 1wCARAT and 1wCARATapp. This indicates 1wkCARAT is valid and reliable, both paper and app version.