title: Control of Allergic Rhinitis and Asthma Test (CARAT) can be used to assess individual patients over time.
abstract: BACKGROUND
  The Control of Allergic Rhinitis and Asthma Test (CARAT10) has been proposed as the first tool to implement the Allergic Rhinitis and its Impact on Asthma initiative guidelines in clinical practice. To serve this purpose, it must have adequate properties to assess the control of an individual over time. This study aimed to prospectively assess the test-retest reliability, responsiveness and longitudinal validity of CARAT10.
  
  
  METHODS
  Adults with asthma and allergic rhinitis were enrolled at 4 outpatient clinics of Portuguese central hospitals. At each of the two visits, 4 to 6 weeks apart, patients filled out CARAT10 and additional questionnaires, followed by a medical evaluation blinded to the questionnaires' answers.
  
  
  RESULTS
  From the 62 patients included, 51 patients completely filled out CARAT10 at both visits. The test-retest reliability, computed as an intra-class correlation coefficient, was 0.82. Regarding responsiveness, a significant change (p = 0.002) of CARAT10 score in clinically unstable patients was observed (95%CI -5.08; -1.31) and the Guyatt's responsiveness index was 1.54. As for the longitudinal validity assessment, the correlation coefficients of the changes of CARAT10 scores with those of ACQ5 and symptoms VAS ranged from 0.49 to 0.65, while with the physician assessment of control they ranged from 0.31 to 0.41.
  
  
  CONCLUSIONS
  CARAT10 has good test-retest reliability, responsiveness and longitudinal validity. It can be used to assess control of allergic rhinitis and asthma, both to compare groups in clinical studies and to evaluate individual patients in clinical practice.
authors.affiliation: Faculdade de Medicina da Universidade do Porto, Health Information and Decision Sciences Department, Porto, Portugal. fonseca.ja@gmail.com.
authors.forename: Joao A
authors.initials: JA
authors.lastname: Fonseca
authors.forename: Luis
authors.initials: L
authors.lastname: Nogueira-Silva
authors.forename: Mario
authors.initials: M
authors.lastname: Morais-Almeida
authors.forename: Ana
authors.initials: A
authors.lastname: Sa-Sousa
authors.forename: Luis F
authors.initials: LF
authors.lastname: Azevedo
authors.forename: Jose
authors.initials: J
authors.lastname: Ferreira
authors.forename: Manuel
authors.initials: M
authors.lastname: Branco-Ferreira
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Rodrigues-Alves
authors.forename: Antonio
authors.initials: A
authors.lastname: Bugalho-Almeida
authors.forename: Jean
authors.initials: J
authors.lastname: Bousquet