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Adaptation to Spanish and validation of the Rhinitis Control Assessment Test (RCAT) questionnaire

Del Cuvillo A1,*, Sastre J2,3,4,*, Colás C5, Navarro AM6, Mullol J4,7,**, Valero A4,8,**

1Rhinology & Asthma Unit. Department of Otorhinolaryngology, Hospital Universitario de Jerez, Jerez, Spain
2Department of Allergy, Fundación Jiménez Díaz, Madrid, Spain
3Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
4CIBERES, Instituto de Salud Carlos III, Spain
5Department of Allergy, Hospital Clínico Lozano Blesa. Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
6Department of Allergy, Hospital El Tomillar, Dos Hermanas, Sevilla, Spain
7Rhinology Unit & Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS, Universitat de Barcelona, Barcelona, Spain
8Department of Pneumology and Allergy, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

*These authors contributed equally as first authors
**These authors contributed equally with senior responsibilities

J Investig Allergol Clin Immunol 2020; Vol. 30(3)
doi: 10.18176/jiaci.0420

Background: The Rhinitis Control Assessment Test (RCAT) is a widely used patient-based questionnaire developed to evaluate control of rhinitis.
Objective: To develop and validate a Spanish version of the RCAT (RCATe).
Methods: After translation and cultural adaptation of the original RCAT, this multicentric observational, prospective study evaluated the properties/attributes of the RCATe assessing its validity, reliability, responsiveness, size effect, minimal important difference and cut point score.
Results: A total of 252 allergic rhinitis (AR) patients from 27 allergy and otolaryngology departments from hospitals throughout Spain were included. Significant and strong correlations were found between the RCATe and the total nasal symptom score and the visual analogue scale (-0.79 and -0.77, respectively; p<0.0001). The RCATe significantly distinguished between patients grouped in different severity or duration AR categories (p<0.001). The internal consistency (Cronbach alpha) was good (0.84) and the test-retest reliability was moderate (0.54 by the physician and 0.49 by the patient). The RCATe responsiveness to change was high and significant (p<0.0001), and linearly correlated with the improvement of AR. The overall size effect was 1.62. The cut-off point to identify patients with adequate AR control was >20 (ROC curve area= 0.746; sensitivity= 58.3%; specificity= 90.9%).
Conclusion: The psychometric evaluation and validation of RCATe indicated good reliability, validity, and responsiveness suggesting it can be effectively used to measure control of AR symptoms by Spanish-speaking patients.

Key words: Allergic rhinitis. Patient-reported outcome. Rhinitis control. Psychometric evaluation. Rhinitis Control Assessment Test