Validity, reliability and interpretability of the Thai version of the urticaria control test (UCT)

Abstract

BackgroundThe Long Form and Short Form of the German (original) version of the Urticaria Control Test (UCT) have shown to be valid and reliable instruments for assessing patients with all types of chronic urticaria (CU). The cutoff scores for identifying patients with well-controlled disease were ≥ 24 and ≥ 12 for Long and Short Forms, respectively. However, the sensitivity to change and minimal clinically important difference (MCID) of the UCT have never been systematically evaluated. This study aimed to investigate the validity, reliability, screening accuracy, sensitivity to change and MCID of the linguistically validated translation of the UCT into the Thai language for assessing CU in the Thai population.MethodsA structured translation and pre-testing were done to cross-culturally adapt the UCT for the Thai language. All measurement properties of both forms of the Thai UCT were validated in 169 patients with CU.ResultsThere were strong correlations between the Thai UCT score and disease activity, health-related quality of life impairment, and disease control (all correlations ≥ 0.7). Good internal consistency and excellent intra-rater reliability were demonstrated. The same cutoff scores to define patients with well-controlled disease should be used as those recommended for the original UCT version. MCIDs equated to increase in scores of 6 and 3 for the Long and Short Forms, respectively, of the Thai UCT should be used to identify patients who had minimal responses. Score increments of ≥10 and ≥ 6 for Long and Short Forms, respectively, should be used to define patients who had marked responses.ConclusionsThis study confirmed the applicability of the UCT for use in Thailand, a country that has a very different language and cultural setting than that of Germany and the United States. Further studies are required to examine the suitability of the UCT for use in the pediatric population.

Omalizumab in patients with chronic spontaneous urticaria nonresponsive to H1‐antihistamine treatment: results of the phase IV open‐label SUNRISE study

“…Overall, 74·6% of patients in our study achieved a UCT score ≥ 12 with omalizumab treatment. Our results confirm that the UCT is a reliable tool to measure disease control, consistent with the findings from a previous study from Thailand in 169 patients with chronic urticaria . Urticaria symptoms vary greatly from one day to another, and the disease condition at the time of presentation to the physician is rarely representative of actual disease status .…”

Urticaria: Collegium Internationale Allergologicum (CIA) Update 2020

“…Patients with CSU present with wheals, angioedema, or both, which is important in the correct selection of the PROMs to use. In patients with wheals (with or without angioedema), the Urticaria Activity Score (UAS) [42][43][44][45], the Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL) [46][47][48][49], and the Urticaria Control Test (UCT) [50][51][52][53][54] are the PROMs of choice to measure disease activity, impact, and control, respectively. In patients with predominant angioedema (with or without wheals), the Angioedema Activity Score (AAS) [55,56], the Angioedema Quality of Life Questionnaire (AE-QoL) [57][58][59], and the Angioedema Control Test (AECT) [59] should be used ( Table 2).…”

“…The UCT strongly correlates with the UAS [54,75], has high levels of validity and reliability, and accurately identifies patients with insufficiently controlled disease. Its MCID is 3 points [52,53]. No version for children is available as of yet.…”

Disease Severity, Activity, Impact, and Control and How to Assess Them in Patients with Hereditary Angioedema

“…Tools that assess disease control, determine the level of control that patients have of their disease at a specific time point. Examples of PRO measures that assess disease control are the asthma control test and the urticaria control test ( 45 – 48 ). Control tests can also be retrospective PRO measures and usually have defined cut off values that indicate poorly controlled disease.…”