Abstract
BackgroundMASK‐air® is an app that supports allergic rhinitis patients in disease control. Users register daily allergy symptoms and their impact on activities using visual analog scales (VASs). We aimed to assess the concurrent validity, reliability, and responsiveness of these daily VASs.MethodsDaily monitoring VAS data were assessed in MASK‐air® users with allergic rhinitis. Concurrent validity was assessed by correlating daily VAS values with those of the EuroQol‐5 Dimensions (EQ‐5D) VAS, the Control of Allergic Rhinitis and Asthma Test (CARAT) score, and the Work Productivity and Activity Impairment Allergic Specific (WPAI‐AS) Questionnaire (work and activity impairment scores). Intra‐rater reliability was assessed in users providing multiple daily VASs within the same day. Test–retest reliability was tested in clinically stable users, as defined by the EQ‐5D VAS, CARAT, or “VAS Work” (i.e., VAS assessing the impact of allergy on work). Responsiveness was determined in users with two consecutive measurements of EQ‐5D‐VAS or “VAS Work” indicating clinical change.ResultsA total of 17,780 MASK‐air® users, with 317,176 VAS days, were assessed. Concurrent validity was moderate–high (Spearman correlation coefficient range: 0.437–0.716). Intra‐rater reliability intraclass correlation coefficients (ICCs) ranged between 0.870 (VAS assessing global allergy symptoms) and 0.937 (VAS assessing allergy symptoms on sleep). Test–retest reliability ICCs ranged between 0.604 and 0.878—“VAS Work” and “VAS asthma” presented the highest ICCs. Moderate/large responsiveness effect sizes were observed—the sleep VAS was associated with lower responsiveness, while the global allergy symptoms VAS demonstrated higher responsiveness.ConclusionIn MASK‐air®, daily monitoring VASs have high intra‐rater reliability and moderate–high validity, reliability, and responsiveness, pointing to a reliable measure of symptom loads.
Highlights
Allergic rhinitis is a burdensome condition contributing to a substantial loss of work and school productivity, as well as to decreased quality of life.[1,2] While there have been important advances on the treatment of allergic rhinitis, many patients remain poorly controlled.[3]
We observed that, overall, daily monitoring visual analog scales (VASs) presented with high intra‐rater reliability and moderate‐high concurrent validity, test–retest reliability and responsiveness
This is relevant when taking into account the fact that, overall, the VAS has been shown to be a simple and sensitive instrument for measuring allergic rhinitis symptoms, having been used in both randomized controlled trials and observational studies.[30]
Summary
Allergic rhinitis is a burdensome condition contributing to a substantial loss of work and school productivity, as well as to decreased quality of life.[1,2] While there have been important advances on the treatment of allergic rhinitis, many patients remain poorly controlled.[3]. - 4 of 15 stability of measures/inputs obtained at different times of the day from the same users (intra‐rater reliability) or on different days in users considered clinically stable (test–retest reliability).[11] On the other hand, responsiveness estimates inform on the ability of daily monitoring VASs to change over a specifc period of time in cases where changes in a reference measure of health status have occurred.[12]. An assessment of such properties is essential for determining whether daily monitoring VASs can be used as a reliable tool for measuring rhinitis control. This study aimed to assess concurrent validity, intra‐rater and test–retest reliability, as well as the responsiveness of MASK‐air® daily monitoring VASs
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