title: Evaluating quality of life in patients with asthma and rhinitis: English adaptation of the rhinasthma questionnaire.
abstract: BACKGROUND
  Separate health-related quality of life (HRQL) instruments exist for asthma and rhinitis. The Rhinasthma questionnaire, originally developed in Italian, is a unique measure designed for use where both conditions coexist.
  
  
  OBJECTIVE
  We sought to assess the performance and validity of a new adaptation of the Rhinasthma questionnaire for use in English-speaking populations.
  
  
  METHODS
  We analyzed cross-sectional data from an ongoing study of adults with asthma and rhinitis (n = 450), asthma alone (n = 75), or rhinitis alone (n = 20). Subjects were administered an English translation of the original 30-item Rhinasthma questionnaire. Health status measures simultaneously assessed include the Short Form (SF)-12, EuroQol (EQ)-5D, and Marks Asthma Quality-of-Life.
  
  
  RESULTS
  Variable cluster analysis of the original 30-item instrument identified 5 discrete item clusters corresponding to the following domains: nasal (5 items), eye (4 items), respiratory (5 items), activity restriction (9 items), and treatment burden (5 items). Two other items were removed because of poor item-cluster correlations. Subjects with concomitant asthma and rhinitis had greater HRQL impairment, as measured by the Rhinasthma, than subjects with either asthma or rhinitis alone. The Rhinasthma correlated significantly (P < .05) with the SF-12, EQ-5D, and Marks Asthma Quality-of-Life in the anticipated direction consistent with the underlying constructs. In multiple logistic regression, poorer Rhinasthma HRQL was associated with significantly (P < .05) increased odds of both asthma- and rhinitis-related disability even after taking into account physical health status as measured by the SF-12.
  
  
  CONCLUSIONS
  The 28-item English adaptation of Rhinasthma performs well in assessing HRQL in patients with asthma, rhinitis, or both conditions combined.
authors.affiliation: Department of Medicine, University of California San Francisco, USA. hubert.chen@ucsf.edu
authors.forename: Hubert
authors.initials: H
authors.lastname: Chen
authors.forename: Miriam G
authors.initials: MG
authors.lastname: Cisternas
authors.forename: Patricia P
authors.initials: PP
authors.lastname: Katz
authors.forename: Theodore A
authors.initials: TA
authors.lastname: Omachi
authors.forename: Laura
authors.initials: L
authors.lastname: Trupin
authors.forename: Edward H
authors.initials: EH
authors.lastname: Yelin
authors.forename: John R
authors.initials: JR
authors.lastname: Balmes
authors.forename: Paul D
authors.initials: PD
authors.lastname: Blanc
mesh_terms: D000328:Adult; D001249:Asthma / Q000523:psychology*; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012220:Rhinitis / Q000523:psychology*; D011795:Surveys and Questionnaires