Validity, reliability, and responsiveness of daily monitoring visual analog scales in MASK‐air®

Abstract

Background MASK‐air® is an app that supports allergic rhinitis patients in disease control. Users register daily allergy symptoms and their impact on activities using visual analog scales (VASs). We aimed to assess the concurrent validity, reliability, and responsiveness of these daily VASs. Methods Daily monitoring VAS data were assessed in MASK‐air® users with allergic rhinitis. Concurrent validity was assessed by correlating daily VAS values with those of the EuroQol‐5 Dimensions (EQ‐5D) VAS, the Control of Allergic Rhinitis and Asthma Test (CARAT) score, and the Work Productivity and Activity Impairment Allergic Specific (WPAI‐AS) Questionnaire (work and activity impairment scores). Intra‐rater reliability was assessed in users providing multiple daily VASs within the same day. Test–retest reliability was tested in clinically stable users, as defined by the EQ‐5D VAS, CARAT, or “VAS Work” (i.e., VAS assessing the impact of allergy on work). Responsiveness was determined in users with two consecutive measurements of EQ‐5D‐VAS or “VAS Work” indicating clinical change. Results A total of 17,780 MASK‐air® users, with 317,176 VAS days, were assessed. Concurrent validity was moderate–high (Spearman correlation coefficient range: 0.437–0.716). Intra‐rater reliability intraclass correlation coefficients (ICCs) ranged between 0.870 (VAS assessing global allergy symptoms) and 0.937 (VAS assessing allergy symptoms on sleep). Test–retest reliability ICCs ranged between 0.604 and 0.878—“VAS Work” and “VAS asthma” presented the highest ICCs. Moderate/large responsiveness effect sizes were observed—the sleep VAS was associated with lower responsiveness, while the global allergy symptoms VAS demonstrated higher responsiveness. Conclusion In MASK‐air®, daily monitoring VASs have high intra‐rater reliability and moderate–high validity, reliability, and responsiveness, pointing to a reliable measure of symptom loads.

Allergen immunotherapy in MASK‐air users in real‐life: Results of a Bayesian mixed‐effects model

“…In addition, observations were clustered by users, country and season, thus taking into account certain potential individual confounders. Finally, MASK‐air ® VAS Global allergy symptoms and VAS Work have revealed high intra‐rater validity and moderate‐high validity, test‐retest reliability and responsiveness 24 …”

“…Finally, MASK‐air ® VAS Global allergy symptoms and VAS Work have revealed high intra‐rater validity and moderate‐high validity, test‐retest reliability and responsiveness. 24 …”

“…MASK‐air ® comprises a daily monitoring questionnaire which assesses the impact of allergic rhinitis using visual analogue scales (VASs) on a 0–100 scale, which display high intra‐rater validity and moderate‐high validity, test‐retest reliability and responsiveness (Supplementary Table S2 ). 24 The questionnaire includes a question on how much overall allergic rhinitis symptoms are bothering the user on that day (‘VAS Global Allergy Symptoms’), as well as one on how much allergic symptoms are affecting work on that day (‘VAS Work’; only presented if the user reports to be working on that day). In addition to the VASs, the MASK‐air ® daily monitoring questionnaire asks users whether they took medication or had been under AIT on that day.…”

“…In addition, observations were clustered by users, country and season, thus taking into account certain potential individual confounders. Finally, MASK-air ® VAS Global allergy symptoms and VAS Work have revealed high intra-rater T A B L E 2 (Continued) C. SLIT-tablet versus no AIT-Mean (CrI) [probability of SLIT-tablet being better than no AIT] −7.5 (−12.1;−2.8) [99%] −5.0 (−8.5;−1.5) [99%] −3.7 (−9.3;2.2) [89%] SLIT-tablet versus SCIT-Mean (CrI) [probability of SLIT-tablet being better than SCIT] −10.2 (−17.5;−2.8) [99%] −7.8 (−15.1;0.2) [97%] −9.3 (−18.5;0.2) [97%]B. Hierarchical models adjusting for the season, country, patient and his/her characteristics (sex, age and comorbidities)Abbreviations: CSMS, combined symptom-medication score; SCIT, subcutaneous immunotherapy; SLIT-tablet, sublingual AIT exclusively by tablets; VAS global allergy symptoms, visual analogue scale assessing the overall impact of allergic rhinitis symptoms on the user on that day; VAS Work, visual analogue scale assessing the work impact of allergic rhinitis symptoms on the user on that day.validity and moderate-high validity, test-retest reliability and responsiveness 24.…”

Validation Parameters of Patient-Generated Data for Digitally Recorded Allergic Rhinitis Symptom and Medication Scores in the @IT.2020 Project: Exploratory Study

“…This is of high priority, as data validation is a prerequisite of any scientific or clinical use of the information collected through mobile apps from patients. A recent study demonstrated that daily monitoring with a VAS score has a high intrarater reliability and medium-high validity, reliability, and responsiveness, suggesting the validity of this simple methodology in monitoring disease impact on the patient’s daily life [ 32 ]. Along the same line of evidence, our study demonstrates that VAS correlates well with complex measurements such as RTSS and CSMS, both in terms of trajectory at the population level ( Figure 1 ) and as average values at the individual level ( Figure 2 ).…”