title: Control of allergic rhinitis and asthma test--a formal approach to the development of a measuring tool.
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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Faculdade de Medicina da Universidade do Porto, Porto, Portugal. luis.nsilva@netcabo.pt
authors.forename: Luis
authors.initials: L
authors.lastname: Nogueira-Silva
authors.forename: Sonia V
authors.initials: SV
authors.lastname: Martins
authors.forename: Ricardo
authors.initials: R
authors.lastname: Cruz-Correia
authors.forename: Luis F
authors.initials: LF
authors.lastname: Azevedo
authors.forename: Mario
authors.initials: M
authors.lastname: Morais-Almeida
authors.forename: António
authors.initials: A
authors.lastname: Bugalho-Almeida
authors.forename: Marianela
authors.initials: M
authors.lastname: Vaz
authors.forename: Altamiro
authors.initials: A
authors.lastname: Costa-Pereira
authors.forename: Joao A
authors.initials: JA
authors.lastname: Fonseca
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis* / Q000628:therapy*; D032921:Consensus; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011174:Portugal; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis* / Q000628:therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis* / Q000628:therapy*; D011795:Surveys and Questionnaires; D055815:Young Adult