Adaptation of the Score for Allergic Rhinitis in the Chinese Population: Psychometric Properties and Diagnostic Accuracy

Abstract

Background: Allergic rhinitis (AR) is a worldwide health problem with rising prevalence. To enhance the estimation of AR prevalence in epidemiological studies, the Score for AR (SFAR), a screening tool, has been developed and widely used. An 8-item SFAR is a handy, self-administered instrument assessing the information on nasal and eye symptoms, seasonal increase in symptoms, skin test results, and previous AR diagnoses. This study aimed to adapt the SFAR to the Chinese population (CSFAR) and validate it by testing its psychometric properties and diagnostic accuracy. Methods: This methodological study involved translation and validation phases. Different batches of participants were recruited for the above purposes. Results: In phase 1, the CSFAR obtained satisfactory item (80-100%) and scale level (97.8%) semantic equivalence, content validity index (96.7%), comprehensibility (100%), cross-language testing (κ = 0.44-0.83 for item-to-item agreement; intraclass correlation coefficient [ICC] = 0.95, p < 0.05-0.001). In phase 2, CSFAR showed satisfactory internal consistency (α = 0.83), 1-month (ICC = 0.88) and 1-year stability (ICC = 0.85), and construct validity (significant correlation between CSFAR and impairments induced by AR: r = 0.47, p < 0.001). Based on the receiver-operating characteristic curve, comparing the CSFAR with diagnosis made by specialists, an optimal cutoff value was 6 (sensitivity 81.8% and specificity 80.3%). Conclusion: SFAR was translated into a Chinese version, the CSFAR. Satisfactory results were obtained for its equivalence, appropriateness, comprehensibility, and relevance, as well as its reliability and validity. A cutoff value of 6 was recommended to increase the diagnostic accuracy in environments with less pollen. This study provides evidence that the SFAR we adapted for the Chinese population is a valuable tool in AR screening.

Adaptation and psychometric testing of the hoarding rating scale (HRS): a self-administered screening scale for epidemiological study in Chinese population

“…Face validity of the CHRS was examined to assess the comprehensibility of each items by the general public, which aimed to ensure the applicability of a self-report method. A purposive sample of 8 to 20, including an appropriate good mix of demographics (e.g., men and women, young and old adults, highly and less educated), were recruited for the face validation process because the literature indicated that this sample size can sufficiently detect ambiguous items [28,39]. These participants were invited to comment each item regarding comprehensibility (i.e., rated on yes/no) and to rephrase them by their own words to check its interpretability (the researcher rated the participants' answers on a 4point Likert scale regarding interpretability, 1 = fully correct to 4 = completely wrong) [24,25].…”

“…A convenience sample of 62 undergraduate students was selected to answer the questionnaire twice (T1 as well as T2, 2 weeks later) [26]. The anonymous T1 and T2 responses collected from each student were matched using self-generated codes (i.e., combinations of mobile and student identity numbers) as described in a previous study [28]. A formula (expected ICC = 0.80, and 95% confidence interval [CI] for ICC = 0.20) with consideration of attrition rate of 20% was adopted to suggest a sample size of 62 [19].…”

Adaptation and validation of the health belief model scale for colorectal cancer screening

“…Cognitive interviewing (also known as cognitive debriefing, Wild et al, 2005) focused on the interpretation of items, rather than on collecting data, in response to items to evaluate sources of response error in the survey questionnaires, and to examine how Koreans understand and interpret the items for the HBM scale. This method was used to ensure the correct interpretability of items from target and respondents' cognitive ability and was commonly used in scale adaptation (Lam et al, 2017;Wild et al, 2005).…”

Development and Psychometric Testing of a Generic Student Engagement Scale for Contemporary Healthcare Education

“…A group of 20 target respondents (i.e., 20 randomly selected students studying in higher education) was invited to comment on the comprehensibility and interpretability of the drafted GSES items, where such method is suggested in the literature [22,23,29].…”

“…Twenty students from several healthcare courses were invited to evaluate the instrument "for assuring the expression of the items was understandable words and style" [29]. The participants inspected and commented on each item to attain comprehensibility (i.e., Yes/No nominal scale), and rephrased each item based on their own words (i.e., the interpretability).…”