Presenter: Corina de Jong PhD Department of General Practice,

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Presentation transcript:

Validation of the ´Control of allergic rhinitis and asthma test´ (CARAT) 1-week version and app Presenter: Corina de Jong PhD Department of General Practice, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, The Netherlands

Conflict of interest No conflicts of interest The study was funded by an unrestricted grant by AstraZeneca

Asthma and allergic rhinitis The most prevalent asthma phenotype is allergic asthma with allergic rhinitis (AR) 70-90% of asthma patients also have AR 40-50% of AR patients also have asthma

Astma en allergische rinitis The ‘Allergic Rhinitis and its Impact on Asthma’ (ARIA) initiative1, recommends concurrent evaluation and treatment of asthma and AR. However, until recently no tool was available to measure both AR and asthma. Prof. Fonseca designed the: Control of Allergic Rhinitis and Asthma Test (CARAT)2. 1: Bousquet J et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update. Allergy 2008. Suppl 86:8-160. 2: Nogueira-Silva et al .Control of allergic rhinitis and asthma test – a formal approach to the development of a measuring tool. Resp. Res. 2009

The CARAT questionnaire 10 questions Total score and 2 subdomains: AR (item 1 - 4) and asthma (item 5 - 10) Covers a 4 week period Validated in original language (Portuguese) Translated and validated in Dutch3 3: van der Leeuw S et al. The minimal clinically important difference of the Control of Allergic Rhinitis and Asthma Test (CARAT); cross-cultural validation and relation with pollen counts.. Prim Care Respir Med 2015.

Validating the 1 week version Validating the digital CARAT-App Aim of the study Validating the 1 week version Validating the digital CARAT-App

Study set-up ARIA: Allergic Rhinitis and its Impact on Asthma – AR severity VAS: Visual Analog Scale- Severity of general, upper and lower airway problems GINA: Global Initiative for Asthma- Asthma severity ACQ: Asthma Control Test- Asthma severity

Statistics plan Internal consistency  Cronbach’s alfa. Hypotheses: Cronbach’s alfa >0.7. This is considered acceptable. Test-retest reliability of the P&P and App Spearman correlation. Hypotheses: all p<0.05. And r>0.5, meaning strong correlation. 4wkCARAT relation with 1wkCARAT  Wilcoxon-Signed-Rank. Hypotheses: No significant difference. Construct validity (using ACQ, VAS, GINA and ARIA)  spearman correlation and students T-test. Hypotheses: Spearman correlation all p<0.05 and r>0.5. Students T-test significant difference in CARAT between mild vs medium/severe rhinitis. App satisfaction  percentages.

Demographics Total 109 participants Gender 39.4 % men Mean age 53 years Median Packyears 11 Mean FEV1 % predicted 93.95

Results Cronbach’s alpha>0.787 for all (sub)scales in both the P&P and the app version. Hypotheses confirmed, good internal consistency Test-retest reliability all p<0.001; r≥0.724 ≤ 0.906. For both the P&P version and the app. Hypotheses confirmed, good test-retest reliability No significant difference between 4wkCARAT and 1wkCARAT, p=0.232. Hypotheses confirmed No significant difference in score between the P&P and the app version.

Results – Construct validity I VAS ACQ GINA General airway complaints Nasal complaints Bronchial/pulmonary CARAT Correlation (P-value) -0.625 0.000 -0.482 -0.574 -0.657 -0.554 CARAT, subscale rhinitis -0.354 -0.569 -0.234 0.014 -0.318 0.001 -0.144 0.007 CARAT, subscale asthma -0.661 -0.259 -0.695 -0.705 -0.670 Hypotheses confirmed, good construct validity

Results – Construct validity II Difference in CARAT-rhinitis score between ARIA mild vs medium/severe rhinitis also significant: p=0.011. Hypotheses confirmed. App satisfaction: 84.4 % of patients found the app (very) easy to use. 41.3 % prefers the app, 4.6% paper, 54.1% liked both.

Conclusion The 1wk CARAT is valid and reliable Both as pen & paper and as app version Making it these useful tools for research and daily practice purposes