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. 2012 Aug 30;2(1):16.
doi: 10.1186/2045-7022-2-16.

Control of Allergic Rhinitis and Asthma Test (CARAT) can be used to assess individual patients over time

Joao A Fonseca  1 , Luis Nogueira-Silva, Mario Morais-Almeida, Ana Sa-Sousa, Luis F Azevedo, Jose Ferreira, Manuel Branco-Ferreira, Rodrigo Rodrigues-Alves, Antonio Bugalho-Almeida, Jean Bousquet
Affiliations

Control of Allergic Rhinitis and Asthma Test (CARAT) can be used to assess individual patients over time

Joao A Fonseca et al. Clin Transl Allergy. .

Abstract

Background: The Control of Allergic Rhinitis and Asthma Test (CARAT10) has been proposed as the first tool to implement the Allergic Rhinitis and its Impact on Asthma initiative guidelines in clinical practice. To serve this purpose, it must have adequate properties to assess the control of an individual over time. This study aimed to prospectively assess the test-retest reliability, responsiveness and longitudinal validity of CARAT10.

Methods: Adults with asthma and allergic rhinitis were enrolled at 4 outpatient clinics of Portuguese central hospitals. At each of the two visits, 4 to 6 weeks apart, patients filled out CARAT10 and additional questionnaires, followed by a medical evaluation blinded to the questionnaires' answers.

Results: From the 62 patients included, 51 patients completely filled out CARAT10 at both visits. The test-retest reliability, computed as an intra-class correlation coefficient, was 0.82. Regarding responsiveness, a significant change (p = 0.002) of CARAT10 score in clinically unstable patients was observed (95%CI -5.08; -1.31) and the Guyatt's responsiveness index was 1.54. As for the longitudinal validity assessment, the correlation coefficients of the changes of CARAT10 scores with those of ACQ5 and symptoms VAS ranged from 0.49 to 0.65, while with the physician assessment of control they ranged from 0.31 to 0.41.

Conclusion: CARAT10 has good test-retest reliability, responsiveness and longitudinal validity. It can be used to assess control of allergic rhinitis and asthma, both to compare groups in clinical studies and to evaluate individual patients in clinical practice.

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Figures

Figure 1
Figure 1
CARAT10 and its subscores plotted against the classifications of rhinitis severity and asthma control, according to ARIA recommendations and GINA guidelines.
Figure 2
Figure 2
Receiver operating characteristic curves and diagnostic test properties of CARAT10’ with composite score of (A) ACQ score and Nasal VAS, (B), GINA and ARIA criteria and (C) ACQ, GINA, Nasal VAS and ARIA.
Figure 3
Figure 3
Receiver operating characteristic curves and diagnostic test properties of CARAT10’ asthma factor with (A) ACQ score, (B) GINE criteria, and (C) a composite score of GINA and ACQ; and CARAT10’ rhinitis factor with (D) ARIA classification, (E) the nasal symptoms VAS and (F) a composite score of ARIA and the symptoms VAS.
See this image and copyright information in PMC

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