AQUA: Allergy Questionnaire for Athletes. Development and validation.
OBJECTIVE
Despite the high and increasing prevalence of allergic diseases in athletes, allergy diagnostics is not part of the routine medical examination in sports medicine. This study reports the development and validation of an easy and reliable questionnaire for screening allergy in athletes.


METHODS
AQUA was derived from the European Community Respiratory Health Survey Questionnaire. On the basis of open interviews with team doctors, coaches, and athletes, questions were added about: the type, duration, and intensity of training; exercise-related allergic and infectious symptoms; social habits (smoking); drug and food supplements intake; antidoping regulations. The final version of the questionnaire, made of 25 selected questions, was validated in 128 professional soccer players who underwent accurate history taking, medical examination, skin prick testing, and/or specific IgE determination. On the basis of the correlation with objective allergy (positive skin tests to at least one allergen), questions were scored from 1 to 5 according to their positive likelihood ratio.


RESULTS
Skin tests (gold standard for validation) were positive in 46.8% of soccer players. Mean total AQUA score was 9.4 +/- 7.8 in allergic athletes versus 1.3 +/- 2.3 in nonallergic athletes. A total AQUA score of >or=5 was shown to have the best positive predictive value for allergy (0.94) with a specificity of 97.1% and a sensitivity of 58.3%.


CONCLUSIONS
AQUA, produced in 10 European languages, is a validated, easy, and reliable tool for calling attention on the high prevalence of allergy in athletes.
Department of Internal Medicine, University of Genoa, Italy.
Matteo
M
Bonini
Fulvio
F
Braido
Ilaria
I
Baiardini
Stefano
S
Del Giacco
Claudia
C
Gramiccioni
Massimo
M
Manara
Giulia
G
Tagliapietra
Anna
A
Scardigno
Vittorio
V
Sargentini
Mario
M
Brozzi
Guido
G
Rasi
Sergio
S
Bonini
D000293:Adolescent; D000328:Adult; D001250:Asthma, Exercise-Induced / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening / Q000295:instrumentation* / Q000379:methods; D012141:Respiratory Tract Infections / Q000453:epidemiology; D012916:Soccer; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult