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Sousa-Pinto B, Eklund P, Pfaar O, Klimek L, Zuberbier T, Czarlewski W, Bédard A, Bindslev-Jensen C, Bedbrook A, Bosnic-Anticevich S, Brussino L, Cardona V, Cruz AA, de Vries G, Devillier P, Fokkens WJ, Fuentes-Pérez JM, Gemicioğlu B, Haahtela T, Huerta-Villalobos YR, Ivancevich JC, Kull I, Kuna P, Kvedariene V, Larenas Linnemann DE, Laune D, Makris M, Melén E, Morais-Almeida M, Mösges R, Mullol J, O'Hehir RE, Papadopoulos NG, Pereira AM, Prokopakis EP, Psarros F, Regateiro FS, Reitsma S, Samolinski B, Scichilone N, da Silva J, Stellato C, Todo-Bom A, Tomazic PV, Salmi ST, Valero A, Valiulis A, Valovirta E, van Eerd M, Ventura MT, Yorgancioglu A, Basagaña X, Antó JM, Bousquet J, Fonseca JA. Validity, reliability, and responsiveness of daily monitoring visual analog scales in MASK-air®. Clin Transl Allergy 2021; 11:e12062. [PMID: 34567526 PMCID: PMC8449952 DOI: 10.1002/clt2.12062] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/07/2021] [Accepted: 08/02/2021] [Indexed: 01/10/2023] Open
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.
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Affiliation(s)
- Bernardo Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences Faculty of Medicine, University of Porto Porto Portugal.,CINTESIS - Center for Health Technology and Services Research University of Porto Porto Portugal.,RISE - Health Research Network University of Porto Porto Portugal
| | - Patrik Eklund
- Department of Computing Science Umeå University Umeå Sweden
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery Section of Rhinology and Allergy University Hospital Marburg Philipps Universität Marburg Marburg Germany
| | - Ludger Klimek
- Department of Otolaryngology, Head and Neck Surgery Universitätsmedizin Mainz Mainz Germany.,Center for Rhinology and Allergology Wiesbaden Germany
| | - Torsten Zuberbier
- Department of Dermatology and Allergy Comprehensive Allergy Center Charité Universitätsmedizin Berlin Humboldt-Universität zu Berlin Berlin Germany
| | - Wienczyslawa Czarlewski
- MASK-air Montpellier France.,Medical Consulting Czarlewski Levallois France.,MACVIA-France Montpellier France
| | - Annabelle Bédard
- ISGlobAL Universitat Pompeu Fabra (UPF) CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain.,Equipe d'Epidémiologie Respiratoire Intégrative Université Paris-Saclay UVSQ Université Paris-Sud INSERM CESP Villejuif France
| | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Centre Odense Research Center for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
| | - Anna Bedbrook
- MASK-air Montpellier France.,MACVIA-France Montpellier France
| | - Sinthia Bosnic-Anticevich
- Quality Use of Respiratory Medicine Group Woolcock Institute of Medical Research The University of Sydney Sydney New South Wales Australia.,Sydney Local Health District Glebe New South Wales Australia
| | - Luisa Brussino
- Department of Medical Sciences Allergy and Clinical Immunology Unit University of Torino & Mauriziano Hospital Torino Italy
| | - Victoria Cardona
- Allergy Section Department of Internal Medicine Hospital Vall d'Hebron & ARADyAL research network Barcelona Spain
| | - Alvaro A Cruz
- Fundação ProAR - Federal University of Bahia Salvador Brazil.,WHO GARD Planning Group Salvador Brazil
| | | | - Philippe Devillier
- Laboratoire de Pharmacologie UPRES EA220 Pôle des Maladies des Voies Respiratoires Hôpital Foch Université Paris-Saclay Suresnes France
| | - Wytske J Fokkens
- Department of Otorhinolaryngology Amsterdam University Medical Centres Amsterdam the Netherlands
| | - José Miguel Fuentes-Pérez
- Hospital General Regional IMSS General Regional Hospital 1 Dr. Carlos Mac Gregor Sanchez Navarro Mexico City Mexico
| | - Bilun Gemicioğlu
- Department of Pulmonary Diseases Istanbul University-Cerrahpaşa Cerrahpasa Faculty of Medicine Istanbul Turkey
| | - Tari Haahtela
- Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland
| | | | | | - Inger Kull
- Department of Clinical Science and Education Södersjukhuset Karolinska Institutet Stockholm Sweden
| | - Piotr Kuna
- Division of Internal Medicine, Asthma and Allergy Barlicki University Hospital Medical University of Lodz Poland
| | - Violeta Kvedariene
- Department of Pathology Faculty of Medicine Institute of Biomedical Sciences Vilnius University Vilnius Lithuania.,Clinic of Chest Diseases and Allergology Faculty of Medicine Institute of Clinical Medicine Vilnius University Vilnius Lithuania
| | | | | | - Michael Makris
- Allergy Unit "D Kalogeromitros" 2nd Dpt of Dermatology and Venereology National & Kapodistrian University of Athens "Attikon" University Hospital Athens Greece
| | - Erik Melén
- Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden.,Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | | | - Ralph Mösges
- Medical Faculty Institute of Medical Statistics, and Computational Biology University of Cologne Cologne Germany.,CRI-Clinical Research International-Ltd Hamburg Germany
| | - Joaquim Mullol
- Rhinology Unit & Smell Clinic ENT Department Hospital Clínic Clinical & Experimental Respiratory Immunoallergy IDIBAPS University of Barcelona CIBERES Barcelona Spain
| | - Robyn E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine Central Clinical School Monash University Melbourne Victoria Australia.,Alfred Health Melbourne Victoria Australia
| | - Nikolaos G Papadopoulos
- Center for Pediatrics and Child Health Institute of Human Development Royal Manchester Children's Hospital University of Manchester Manchester UK.,Allergy Department 2nd Pediatric Clinic Athens General Children's Hospital "P&A Kyriakou" University of Athens Athens Greece
| | - Ana Margarida Pereira
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences Faculty of Medicine, University of Porto Porto Portugal.,CINTESIS - Center for Health Technology and Services Research University of Porto Porto Portugal.,RISE - Health Research Network University of Porto Porto Portugal
| | - Emmanuel P Prokopakis
- Department of Otorhinolaryngology University of Crete School of Medicine Heraklion Greece
| | - Fotis Psarros
- Allergy Department Athens Naval Hospital Athens Greece
| | - Frederico S Regateiro
- Allergy and Clinical Immunology Unit Institute of Immunology Faculty of Medicine Centro Hospitalar e Universitário de Coimbra University of Coimbra Coimbra Portugal.,Faculty of Medicine ICBR - Coimbra Institute for Clinical and Biomedical Research CIBB University of Coimbra Coimbra Portugal
| | - Sietze Reitsma
- Department of Otorhinolaryngology Amsterdam University Medical Centres Amsterdam the Netherlands
| | - Boleslaw Samolinski
- Department of Prevention of Environmental Hazards and Allergology Medical University of Warsaw Warsaw Poland
| | | | - Jane da Silva
- Allergy Service Internal Medicine Department University Hospital of Federal University of Santa Catarina (HU-UFSC) Florianópolis Brazil
| | - Cristiana Stellato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno Salerno Italy
| | - Ana Todo-Bom
- Allergy and Clinical Immunology Unit Institute of Immunology Faculty of Medicine Centro Hospitalar e Universitário de Coimbra University of Coimbra Coimbra Portugal.,Faculty of Medicine ICBR - Coimbra Institute for Clinical and Biomedical Research CIBB University of Coimbra Coimbra Portugal
| | | | | | - Antonio Valero
- Pneumology and Allergy Department CIBERES and Clinical & Experimental Respiratory Immunoallergy IDIBAPS University of Barcelona Spain
| | - Arunas Valiulis
- Department of Public Health Vilnius University Institute of Clinical Medicine Clinic of Children's Diseases Institute of Health Sciences Vilnius Lithuania.,European Academy of Paediatrics (EAP/UEMS-SP) Brussels Belgium
| | - Erkka Valovirta
- Department of Lung Diseases and Clinical Immunology University of Turku Turku Finland.,Terveystalo Allergy Clinic Turku Finland
| | | | - Maria Teresa Ventura
- Unit of Geriatric Immunoallergology University of Bari Medical School Bari Italy
| | - Arzu Yorgancioglu
- Department of Pulmonary Diseases Faculty of Medicine Celal Bayar University Manisa Turkey
| | - Xavier Basagaña
- ISGlobAL Universitat Pompeu Fabra (UPF) CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain.,Universitat Pompeu Fabra (UPF) Barcelona Spain.,CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
| | - Josep M Antó
- ISGlobAL Universitat Pompeu Fabra (UPF) CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain.,Universitat Pompeu Fabra (UPF) Barcelona Spain.,CIBER Epidemiología y Salud Pública (CIBERESP) Barcelona Spain.,IMIM (Hospital del Mar Research Institute) Barcelona Spain
| | - Jean Bousquet
- Department of Dermatology and Allergy Comprehensive Allergy Center Charité Universitätsmedizin Berlin Humboldt-Universität zu Berlin Berlin Germany.,MACVIA-France Montpellier France.,Centre Hospitalier Universitaire Montpellier France
| | - João Almeida Fonseca
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences Faculty of Medicine, University of Porto Porto Portugal.,CINTESIS - Center for Health Technology and Services Research University of Porto Porto Portugal.,RISE - Health Research Network University of Porto Porto Portugal
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