Research

Control of allergic rhinitis and asthma test – a formal approach to the development of a measuring tool

Luis Nogueira-Silva¹ , Sonia V Martins¹ , Ricardo Cruz-Correia² , Luis F Azevedo² , Mario Morais-Almeida³ , António Bugalho-Almeida⁴ , Marianela Vaz⁵ , Altamiro Costa-Pereira² and Joao A Fonseca⁶

¹  Serviço de Biostatística e Informática Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal

²  Serviço de Biostatística e Informática Médica and CINTESIS – Centro de Investigação em Tecnologias e Sistemas de Informação em Saúde, Faculdade de Medicina da Universidade do Porto, Porto, Portugal

³  Clínica Universitária de Pneumologia, Faculdade de Medicina da Universidade de Lisboa and Unidade de Imunoalergologia, Hospital CUF-Descobertas, Lisboa, Portugal

⁴  Clínica Universitária de Pneumologia, Faculdade de Medicina da Universidade de Lisboa and Centro Hospitalar Lisboa Norte, Lisboa, Portugal

⁵  Associação Portuguesa de Asmáticos, Porto, Portugal

⁶  Serviço de Biostatística e Informática Médica, CINTESIS – Centro de Investigação em Tecnologias e Sistemas de Informação em Saúde and Faculdade de Medicina da Universidade do Porto and Serviço de Imunoalergologia, Hospital de S. João, EPE, Porto, Portugal

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Respiratory Research 2009, 10:52doi:10.1186/1465-9921-10-52

Published:	17 June 2009

Abstract

Background

The concurrent management of allergic rhinitis and asthma (ARA) has been recommended by Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines. However, a tool capable of assessing simultaneously the control of upper and lower airways diseases is lacking.

Aim

To describe the studies conducted to design the control of ARA test (CARAT) questionnaire.

Methods

We performed a literature review to generate a list of potentially important items for the assessment of control of ARA. A formal consensus development process, that used an innovative web-based application, was designed – 111 experts in ARA and 60 patients participated. At the final consensus meeting, 25 primary and secondary care physicians formulated the questions and response options. A qualitative feasibility study (n = 31 patients) was conducted to evaluate the comprehensibility of the questionnaire while testing two different designs.

Results

Thirty-four potentially important items were identified. All the steps of the consensus process were completed in 2.5 months. The opinions of experts and patients lead to the formulation of 17 questions. At the feasibility study the instructions and wording problems were corrected and a semi-tabular format was chosen.

Conclusion

A tool to measure the control of allergic rhinitis and asthma was developed using a comprehensive set of methodological steps ensuring the design quality and the face and content validity. Additional validation studies to assess the psychometric properties of the questionnaire have started.