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

Abstract

The Control of Allergic Rhinitis and Asthma Test (CARAT) is a patient‐reported outcome measurement (PROM) assessing the control of asthma and allergic rhinitis (AR) at a 4 week interval. This systematic review aimed to evaluate the measurement properties of CARAT. Following PRISMA and COSMIN guidelines, we searched five bibliographic databases and retrieved studies concerning the development, assessment of properties, validation, and/or cultural adaption of CARAT. The studies' methodological quality, the quality of measurement properties, and the overall quality of evidence were assessed. We performed meta‐analysis of CARAT measurement properties. We included 16 studies. Control of Allergic Rhinitis and Asthma Test displayed sufficient content validity and very good consistency (meta‐analytical Cronbach alpha = 0.83; 95% CI = 0.80–0.86;I2 = 62.6%). Control of allergic rhinitis and Asthma Test meta‐analytical intraclass correlation coefficient was 0.91 (95% CI = 0.64–0.98;I2 = 93.7%). It presented good construct validity, especially for correlations with Patient‐reported outcome measures assessing asthma (absolute Spearman correlation coefficients range = 0.67–0.73; moderate quality of evidence), and good responsiveness. Its minimal important difference is 3.5. Overall, CARAT has good internal consistency, reliability, construct validity and responsiveness, despite the heterogeneous quality of evidence. Control of Allergic Rhinitis and Asthma Test can be used to assess the control of asthma and AR. As first of its kind, this meta‐analysis of CARAT measurement properties sets a stronger level of evidence for asthma and/or AR control questionnaires.

Development and validation of an electronic daily control score for asthma (e-DASTHMA): a real-world direct patient data study

“…We obtained similar results when assessing daily asthma control scores in the 2022 MASK-air internal validation cohort (appendix pp [14][15]. However, because of sample size limitations, we were not able to assess test-retest reliability and responsiveness with all comparators.…”

“…(1) CARAT, which assesses the control of allergic rhinitis and asthma in the previous 4 weeks, 15 and can be divided into two components: CARAT rhinitis questions (questions 1-4) and CARAT asthma questions (questions 5-10); (2) Work Productivity and Activity Impairment: Allergy Specic (WPAI:AS), which is a nine-item questionnaire assessing the productivity eect of allergies over the previous week 16 (both the percent overall work impairment due to allergy [WPAI:AS work] and the degree allergy aected regular activities [WPAI:AS activities], both expressed as percentages, were used as comparators); and (3) EQ-5D-5L, which assesses the respondents' health status through ve dimensions or questions followed by a VAS assessing the Panel: Formula for the computation of data-driven electronic daily control scores for asthma…”

Symptoms of anxiety and depression in patients with persistent asthma: a cross-sectional analysis of the INSPIRERS studies

“…A score >24 indicates good disease control 27. This questionnaire has been widely used in clinical practice and in scientific research, being translated/culturally adapted in >27 languages and used in >15 different countries 28…”

UCRAID (Ukrainian Citizen and refugee electronic support in Respiratory diseases, Allergy, Immunology and Dermatology) action plan

“…Additional questionnaires are included: EQ-ED-5L, allowing the assessment of utilities, and CARAT (Control of Allergic Rhinitis and Asthma Test). 38,39 The maturity level of MASK-air® in rhinitis ranges from Technology Readiness Levels (TRLs) 8 to 9. MASK-air® is combined with the prediction of the allergen season and air quality (pollution) using COPERNICUS data (Finnish Meteorological Institute).…”