Reliability, validity, and responsiveness of the Rhinitis Control Assessment Test in patients with rhinitis

• Published in: Journal of allergy and clinical immunology Vol. 131; no. 2; pp. 379 - 386
• Main Authors: Meltzer, Eli O., MD, Schatz, Michael, MD, Nathan, Robert, MD, Garris, Cindy, MS, Stanford, Richard H., PharmD, MS, Kosinski, Mark, MS
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.02.2013; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Allergic rhinitis; Allergies; Allergy and Immunology; Asthma; Biological and medical sciences; Diagnostic Self Evaluation; Disease control; Evaluation Studies as Topic; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Geriatrics; Humans; Immunopathology; Longitudinal Studies; Male; Medical sciences; Middle Aged; Non tumoral diseases; nonallergic rhinitis; Nose; Otorhinolaryngology. Stomatology; patient-reported outcome; Patients; Ratings & rankings; Reproducibility of Results; Review boards; Rhinitis; Rhinitis - diagnosis; Rhinitis - physiopathology; rhinitis control; Rhinitis Control Assessment Test; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Severity of Illness Index; Surveys and Questionnaires; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Validity; Young Adult; United States > US; PAR; Rhinitis Control Assessment Test; RCAT; Seasonal allergic rhinitis; Perennial allergic rhinitis; SAR; ROC; MID; PRO; nonallergic rhinitis; Receiver operating characteristic; Allergic rhinitis; patient-reported outcome; rhinitis control; Minimal important difference; TNSS; Total Nasal Symptom Score; NAR; Human; Allergy; Immunopathology; Nose disease; Prognosis; Rhinitis; Validity; Immunology; ENT disease; Evolution; Reliability
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2012.10.022

Background The Rhinitis Control Assessment Test (RCAT) is a brief, patient-completed tool to evaluate rhinitis symptom control. Objective We sought to test the reliability, validity, and responsiveness of RCAT and to estimate a cut-point score and minimal important difference (MID). Methods A total of 402 patients 12 years of age and older with allergic or nonallergic rhinitis were enrolled in a noninterventional study. Patients completed the RCAT (6 items; score range, 6-30) and had Total Nasal Symptom Scores (TNSSs) measured at baseline and 2 weeks later. Physicians completed a global assessment of rhinitis symptom control (Physician's Global Assessment) and disease severity. Internal consistency, test-retest reliability, convergent validity, known-groups validity, and responsiveness were evaluated. The MID was determined by using distribution- and anchor-based methods. Content validity of the RCAT was assessed in individual interviews with a separate group of 58 adult patients. Results Internal consistency and test-retest reliability of RCAT scores were 0.77 and 0.78, respectively. Convergent validity correlation between RCAT and TNSS scores was 0.57, and that between RCAT and Physician's Global Assessment scores was 0.34. Mean RCAT scores differed significantly ( P  < .001) across patient groups, differing in TNSS (F = 72.7), Physician's Global Assessment score (F = 28.6), and disease severity (F = 34.1) in the hypothesized direction. Results suggested a cut-point score of 21 or less can be used to identify patients who are experiencing rhinitis symptom control problems. The preliminary estimate of the MID was 3 points. Patients found RCAT items comprehensive, easy to understand, and relevant. Conclusion The RCAT demonstrated adequate reliability, validity, and responsiveness and was deemed acceptable and appropriate by patients. This tool can facilitate the detection of rhinitis symptom control problems, and its brevity supports its usefulness in clinical care.