过敏症和哮喘控制测试（CARAT）的最小临床重要差异：跨文化验证及其与花粉计数的关系。
The minimal clinically important difference of the Control of Allergic Rhinitis and Asthma Test (CARAT): cross-cultural validation and relation with pollen counts.
机构信息
1] Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands [2] GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Pulmonology, University Medical Center St Radboud, Nijmegen, The Netherlands.
出版信息
NPJ Prim Care Respir Med. 2015 Jan 8;25:14107. doi: 10.1038/npjpcrm.2014.107.
BACKGROUND
The Control of Allergic Rhinitis and Asthma Test (CARAT) monitors control of asthma and allergic rhinitis.
AIMS
To determine the CARAT's minimal clinically important difference (MCID) and to evaluate the psychometric properties of the Dutch CARAT.
METHODS
CARAT was applied in three measurements at 1-month intervals. Patients diagnosed with asthma and/or rhinitis were approached. MCID was evaluated using Global Rating of Change (GRC) and standard error of measurement (s.e.m.). Cronbach's alpha was used to evaluate internal consistency. Spearman's correlation coefficients were calculated between CARAT, the Asthma Control Questionnaire (ACQ5) and the Visual Analog Scale (VAS) on airway symptoms to determine construct and longitudinal validity. Test-retest reliability was evaluated with intra-class correlation coefficient (ICC). Changes in pollen counts were compared with delta CARAT and ACQ5 scores.
RESULTS
A total of 92 patients were included. The MCID of the CARAT was 3.50 based on GRC scores; the s.e.m. was 2.83. Cronbach's alpha was 0.82. Correlation coefficients between CARAT and ACQ5 and VAS questions ranged from 0.64 to 0.76 (P < 0.01). Longitudinally, correlation coefficients between delta CARAT scores and delta ACQ5 and VAS scores ranged from 0.41 to 0.67 (P < 0.01). Test-retest reliability showed an ICC of 0.81 (P < 0.01) and 0.80 (P < 0.01). Correlations with pollen counts were higher for CARAT than for ACQ5.
CONCLUSIONS
This is the first investigation of the MCID of the CARAT. The CARAT uses a whole-point scale, which suggests that the MCID is 4 points. The CARAT is a valid and reliable tool that is also applicable in the Dutch population.
背景
过敏鼻炎和哮喘测试（CARAT）监测哮喘和过敏鼻炎的控制情况。
目的
确定 CARAT 的最小临床重要差异（MCID），并评估荷兰 CARAT 的心理测量学特性。
方法
在 1 个月的间隔内进行了三次 CARAT 测试。对诊断为哮喘和/或鼻炎的患者进行了调查。使用总体变化评级（GRC）和测量标准误差（s.e.m.）来评估 MCID。Cronbach's alpha 用于评估内部一致性。计算 CARAT、哮喘控制问卷（ACQ5）和气道症状的视觉模拟量表（VAS）之间的 Spearman 相关系数，以确定结构和纵向有效性。使用组内相关系数（ICC）评估测试-再测试的可靠性。将花粉计数的变化与 delta CARAT 和 ACQ5 评分进行比较。
结果
共纳入 92 例患者。基于 GRC 评分，CARAT 的 MCID 为 3.50；s.e.m.为 2.83。Cronbach's alpha 为 0.82。CARAT 与 ACQ5 和 VAS 问题的相关系数范围为 0.64 至 0.76（P < 0.01）。纵向来看，delta CARAT 评分与 delta ACQ5 和 VAS 评分之间的相关系数范围为 0.41 至 0.67（P < 0.01）。测试-再测试的可靠性显示 ICC 为 0.81（P < 0.01）和 0.80（P < 0.01）。与花粉计数的相关性，CARAT 优于 ACQ5。
结论
这是对 CARAT 的 MCID 的首次调查。CARAT 使用整数值刻度，这表明 MCID 为 4 分。CARAT 是一种有效且可靠的工具，也适用于荷兰人群。
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