The minimal clinically important difference of the control of allergic rhinitis and asthma test (CARAT): cross-cultural validation and relation with pollen counts

Sander van der Leeuw; Thys van der Molen; P. N. Richard Dekhuijzen; Joao A. Fonseca; Frederik A. van Gemert; Roy Gerth van Wijk; Janwillem W. H. Kocks; Helma Oosterom; Roland A.  Riemersma; Ioanna G. Tsiligianni; Letty A. de Weger; H. N. G. Oude Elberink; Bertine M. J. Flokstra-de Blok

doi:10.1038/npjpcrm.2014.107

The minimal clinically important difference of the control of allergic rhinitis and asthma test (CARAT): cross-cultural validation and relation with pollen counts

Sander van der Leeuw, Thys van der Molen, P. N. Richard Dekhuijzen, Joao A. Fonseca, Frederik A. van Gemert, Roy Gerth van Wijk, Janwillem W. H. Kocks, Helma Oosterom, Roland A. Riemersma, Ioanna G. Tsiligianni, Letty A. de Weger, H. N. G. Oude Elberink, Bertine M. J. Flokstra-de Blok^*

^*Corresponding author for this work

Groningen Research Institute for Asthma and COPD (GRIAC)

Research output: Contribution to journal › Article › Academic › peer-review

24 Citations (Scopus)

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Abstract

BACKGROUND: The Control of Allergic Rhinitis and Asthma Test (CARAT) monitors control of asthma and allergic rhinitis.

AIMS: To determine the CARAT's minimal clinically important difference (MCID) and to evaluate the psychometric properties of the Dutch CARAT.

METHODS: CARAT was applied in three measurements at 1-month intervals. Patients diagnosed with asthma and/or rhinitis were approached. MCID was evaluated using Global Rating of Change (GRC) and standard error of measurement (s.e.m.). Cronbach's alpha was used to evaluate internal consistency. Spearman's correlation coefficients were calculated between CARAT, the Asthma Control Questionnaire (ACQ5) and the Visual Analog Scale (VAS) on airway symptoms to determine construct and longitudinal validity. Test-retest reliability was evaluated with intra-class correlation coefficient (ICC). Changes in pollen counts were compared with delta CARAT and ACQ5 scores.

RESULTS: A total of 92 patients were included. The MCID of the CARAT was 3.50 based on GRC scores; the s.e.m. was 2.83. Cronbach's alpha was 0.82. Correlation coefficients between CARAT and ACQ5 and VAS questions ranged from 0.64 to 0.76 (P <0.01). Longitudinally, correlation coefficients between delta CARAT scores and delta ACQ5 and VAS scores ranged from 0.41 to 0.67 (P <0.01). Test-retest reliability showed an ICC of 0.81 (P <0.01) and 0.80 (P <0.01). Correlations with pollen counts were higher for CARAT than for ACQ5.

CONCLUSIONS: This is the first investigation of the MCID of the CARAT. The CARAT uses a whole-point scale, which suggests that the MCID is 4 points. The CARAT is a valid and reliable tool that is also applicable in the Dutch population.

Original language	English
Article number	14107
Number of pages	6
Journal	Primary Care Respiratory Medicine
Volume	25
DOIs	https://doi.org/10.1038/npjpcrm.2014.107
Publication status	Published - 8-Jan-2015

Keywords

QUALITY-OF-LIFE
HEALTH-STATUS
QUESTIONNAIRE
TRIAL
RISK
SCORE

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van der Leeuw, S., van der Molen, T., Dekhuijzen, P. N. R., Fonseca, J. A., van Gemert, F. A., van Wijk, R. G., Kocks, J. W. H., Oosterom, H., Riemersma, R. A., Tsiligianni, I. G., de Weger, L. A., Oude Elberink, H. N. G., & Flokstra-de Blok, B. M. J. (2015). The minimal clinically important difference of the control of allergic rhinitis and asthma test (CARAT): cross-cultural validation and relation with pollen counts. Primary Care Respiratory Medicine, 25, [14107]. https://doi.org/10.1038/npjpcrm.2014.107

van der Leeuw, Sander ; van der Molen, Thys ; Dekhuijzen, P. N. Richard ; Fonseca, Joao A. ; van Gemert, Frederik A. ; van Wijk, Roy Gerth ; Kocks, Janwillem W. H. ; Oosterom, Helma ; Riemersma, Roland A. ; Tsiligianni, Ioanna G. ; de Weger, Letty A. ; Oude Elberink, H. N. G. ; Flokstra-de Blok, Bertine M. J. / The minimal clinically important difference of the control of allergic rhinitis and asthma test (CARAT) : cross-cultural validation and relation with pollen counts. In: Primary Care Respiratory Medicine. 2015 ; Vol. 25.

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title = "The minimal clinically important difference of the control of allergic rhinitis and asthma test (CARAT): cross-cultural validation and relation with pollen counts",

abstract = "BACKGROUND: The Control of Allergic Rhinitis and Asthma Test (CARAT) monitors control of asthma and allergic rhinitis.AIMS: To determine the CARAT's minimal clinically important difference (MCID) and to evaluate the psychometric properties of the Dutch CARAT.METHODS: CARAT was applied in three measurements at 1-month intervals. Patients diagnosed with asthma and/or rhinitis were approached. MCID was evaluated using Global Rating of Change (GRC) and standard error of measurement (s.e.m.). Cronbach's alpha was used to evaluate internal consistency. Spearman's correlation coefficients were calculated between CARAT, the Asthma Control Questionnaire (ACQ5) and the Visual Analog Scale (VAS) on airway symptoms to determine construct and longitudinal validity. Test-retest reliability was evaluated with intra-class correlation coefficient (ICC). Changes in pollen counts were compared with delta CARAT and ACQ5 scores.RESULTS: A total of 92 patients were included. The MCID of the CARAT was 3.50 based on GRC scores; the s.e.m. was 2.83. Cronbach's alpha was 0.82. Correlation coefficients between CARAT and ACQ5 and VAS questions ranged from 0.64 to 0.76 (P <0.01). Longitudinally, correlation coefficients between delta CARAT scores and delta ACQ5 and VAS scores ranged from 0.41 to 0.67 (P <0.01). Test-retest reliability showed an ICC of 0.81 (P <0.01) and 0.80 (P <0.01). Correlations with pollen counts were higher for CARAT than for ACQ5.CONCLUSIONS: This is the first investigation of the MCID of the CARAT. The CARAT uses a whole-point scale, which suggests that the MCID is 4 points. The CARAT is a valid and reliable tool that is also applicable in the Dutch population.",

keywords = "QUALITY-OF-LIFE, HEALTH-STATUS, QUESTIONNAIRE, TRIAL, RISK, SCORE",

author = "{van der Leeuw}, Sander and {van der Molen}, Thys and Dekhuijzen, {P. N. Richard} and Fonseca, {Joao A.} and {van Gemert}, {Frederik A.} and {van Wijk}, {Roy Gerth} and Kocks, {Janwillem W. H.} and Helma Oosterom and Riemersma, {Roland A.} and Tsiligianni, {Ioanna G.} and {de Weger}, {Letty A.} and {Oude Elberink}, {H. N. G.} and {Flokstra-de Blok}, {Bertine M. J.}",

year = "2015",

month = jan,

day = "8",

doi = "10.1038/npjpcrm.2014.107",

language = "English",

volume = "25",

journal = "Primary Care Respiratory Medicine",

issn = "2055-1010",

publisher = "SPRINGERNATURE",

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van der Leeuw, S, van der Molen, T, Dekhuijzen, PNR, Fonseca, JA, van Gemert, FA, van Wijk, RG, Kocks, JWH , Oosterom, H, Riemersma, RA, Tsiligianni, IG, de Weger, LA, Oude Elberink, HNG & Flokstra-de Blok, BMJ 2015, 'The minimal clinically important difference of the control of allergic rhinitis and asthma test (CARAT): cross-cultural validation and relation with pollen counts', Primary Care Respiratory Medicine, vol. 25, 14107. https://doi.org/10.1038/npjpcrm.2014.107

The minimal clinically important difference of the control of allergic rhinitis and asthma test (CARAT) : cross-cultural validation and relation with pollen counts. / van der Leeuw, Sander; van der Molen, Thys; Dekhuijzen, P. N. Richard; Fonseca, Joao A.; van Gemert, Frederik A.; van Wijk, Roy Gerth; Kocks, Janwillem W. H.; Oosterom, Helma; Riemersma, Roland A. ; Tsiligianni, Ioanna G.; de Weger, Letty A.; Oude Elberink, H. N. G.; Flokstra-de Blok, Bertine M. J.

In: Primary Care Respiratory Medicine, Vol. 25, 14107, 08.01.2015.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - The minimal clinically important difference of the control of allergic rhinitis and asthma test (CARAT)

T2 - cross-cultural validation and relation with pollen counts

AU - van der Leeuw, Sander

AU - van der Molen, Thys

AU - Dekhuijzen, P. N. Richard

AU - Fonseca, Joao A.

AU - van Gemert, Frederik A.

AU - van Wijk, Roy Gerth

AU - Kocks, Janwillem W. H.

AU - Oosterom, Helma

AU - Riemersma, Roland A.

AU - Tsiligianni, Ioanna G.

AU - de Weger, Letty A.

AU - Oude Elberink, H. N. G.

AU - Flokstra-de Blok, Bertine M. J.

PY - 2015/1/8

Y1 - 2015/1/8

N2 - BACKGROUND: The Control of Allergic Rhinitis and Asthma Test (CARAT) monitors control of asthma and allergic rhinitis.AIMS: To determine the CARAT's minimal clinically important difference (MCID) and to evaluate the psychometric properties of the Dutch CARAT.METHODS: CARAT was applied in three measurements at 1-month intervals. Patients diagnosed with asthma and/or rhinitis were approached. MCID was evaluated using Global Rating of Change (GRC) and standard error of measurement (s.e.m.). Cronbach's alpha was used to evaluate internal consistency. Spearman's correlation coefficients were calculated between CARAT, the Asthma Control Questionnaire (ACQ5) and the Visual Analog Scale (VAS) on airway symptoms to determine construct and longitudinal validity. Test-retest reliability was evaluated with intra-class correlation coefficient (ICC). Changes in pollen counts were compared with delta CARAT and ACQ5 scores.RESULTS: A total of 92 patients were included. The MCID of the CARAT was 3.50 based on GRC scores; the s.e.m. was 2.83. Cronbach's alpha was 0.82. Correlation coefficients between CARAT and ACQ5 and VAS questions ranged from 0.64 to 0.76 (P <0.01). Longitudinally, correlation coefficients between delta CARAT scores and delta ACQ5 and VAS scores ranged from 0.41 to 0.67 (P <0.01). Test-retest reliability showed an ICC of 0.81 (P <0.01) and 0.80 (P <0.01). Correlations with pollen counts were higher for CARAT than for ACQ5.CONCLUSIONS: This is the first investigation of the MCID of the CARAT. The CARAT uses a whole-point scale, which suggests that the MCID is 4 points. The CARAT is a valid and reliable tool that is also applicable in the Dutch population.

AB - BACKGROUND: The Control of Allergic Rhinitis and Asthma Test (CARAT) monitors control of asthma and allergic rhinitis.AIMS: To determine the CARAT's minimal clinically important difference (MCID) and to evaluate the psychometric properties of the Dutch CARAT.METHODS: CARAT was applied in three measurements at 1-month intervals. Patients diagnosed with asthma and/or rhinitis were approached. MCID was evaluated using Global Rating of Change (GRC) and standard error of measurement (s.e.m.). Cronbach's alpha was used to evaluate internal consistency. Spearman's correlation coefficients were calculated between CARAT, the Asthma Control Questionnaire (ACQ5) and the Visual Analog Scale (VAS) on airway symptoms to determine construct and longitudinal validity. Test-retest reliability was evaluated with intra-class correlation coefficient (ICC). Changes in pollen counts were compared with delta CARAT and ACQ5 scores.RESULTS: A total of 92 patients were included. The MCID of the CARAT was 3.50 based on GRC scores; the s.e.m. was 2.83. Cronbach's alpha was 0.82. Correlation coefficients between CARAT and ACQ5 and VAS questions ranged from 0.64 to 0.76 (P <0.01). Longitudinally, correlation coefficients between delta CARAT scores and delta ACQ5 and VAS scores ranged from 0.41 to 0.67 (P <0.01). Test-retest reliability showed an ICC of 0.81 (P <0.01) and 0.80 (P <0.01). Correlations with pollen counts were higher for CARAT than for ACQ5.CONCLUSIONS: This is the first investigation of the MCID of the CARAT. The CARAT uses a whole-point scale, which suggests that the MCID is 4 points. The CARAT is a valid and reliable tool that is also applicable in the Dutch population.

KW - QUALITY-OF-LIFE

KW - HEALTH-STATUS

KW - QUESTIONNAIRE

KW - TRIAL

KW - RISK

KW - SCORE

U2 - 10.1038/npjpcrm.2014.107

DO - 10.1038/npjpcrm.2014.107

M3 - Article

C2 - 25569880

VL - 25

JO - Primary Care Respiratory Medicine

JF - Primary Care Respiratory Medicine

SN - 2055-1010

M1 - 14107

ER -