Turkish language validity and reliability of the Control of Allergic Rhinitis and Asthma Test and its comparison with other scales

Abstract

Objectives Patients with asthma often suffer from concomitant allergic rhinitis (AR). The Control of Allergic Rhinitis and Asthma Test (CARAT) is a validated tool to assess asthma and rhinitis multimorbidity. Turkish language validity and reliability of CARAT and its compatibility with other scales were evaluated in the study. Methods Patients with asthma and concomitant AR were tested with CARAT. Pulmonary function tests, Asthma Control Test (ACT), Assessment Tool for Asthma (ATA) questionnaire and visual analogue scale (VAS) were also used at the same day. With the VAS, patients determined their rhinitis symptom levels, and asthma specialist determined the rhinitis and asthma control levels separately. These questionnaires were repeated in 14 ± 2 days. Results Three quarters (77%) of the 100 patients were female (mean age 46.5 years). The mean CARAT score was 19.6 ± 7.2. The Cronbach's alpha coefficient of the Turkish version of the CARAT scale was 0.83, showing a high level of internal consistency. Test–retest reliability coefficient was determined as r = 0.98 (p < 0.001). The Kaiser–Meyer–Olkin coefficient of the CARAT scale was 0.79. The p value of the Bartlett test was <0.001. ACT, ATA and VAS expert scales were correlated with CARAT total score (0.577 ≤ r ≤ 0.871). The CARAT scale did not show statistically significant difference according to gender, education, working status, smoking status, presence of polyps and multiple allergen sensitivity (p > 0.05). Conclusion The Turkish version of the CARAT is a reliable alternative tool for physicians in determining disease control in adult patients with asthma and AR.

Control of Allergic Rhinitis and Asthma Test: A systematic review of measurement properties and COSMIN analysis

“…Construct (convergent) validity was assessed in 14 studies (published in 20 reports), 18–22,35–46,48–50 but one of them did not report correlation coefficients nor areas under the ROC curve 45 . For CARAT, 12 studies out of 13 studies (92%) showed ‘sufficient’ evidence for construct validity 18–22,35–40,42–44,46,48–50 . Eight studies assessed the construct validity for the CARAT subscales 18–22,35–39,48–50 and ‘sufficient’ evidence for construct validity was found in 6 (75%) studies for the upper airway subscale, 18,20–22,35,38,48–50 and 7 (87.5%) studies for the lower airway subscale 18,20–22,35–38,48–50 …”

“…We included 16 original studies (published throughout 23 reports) in our systematic review (Table 1). 17–22,34–50 …”

“…The internal consistency of CARAT was assessed in 7 studies (published in 8 reports) 17,18,20–22,35,46,47 . Additionally, five of these studies reported on the internal consistency of CARAT subscales 17,18,20–22,35 .…”

“…Three studies (published in four reports) assessed the reliability of CARAT 17,18,20,21 . The reliability was qualitatively rated as ‘adequate’, as all studies resulted in an ICC of 0.70 or higher 17,18,20,21 .…”

“…Construct (convergent) validity was assessed in 14 studies (published in 20 reports), 18–22,35–46,48–50 but one of them did not report correlation coefficients nor areas under the ROC curve 45 . For CARAT, 12 studies out of 13 studies (92%) showed ‘sufficient’ evidence for construct validity 18–22,35–40,42–44,46,48–50 .…”