过敏性鼻炎的控制和哮喘检测：一种检测工具的建立
2009/08/11
背景：《过敏性鼻炎及其对哮喘的影响（ARIA）指南》推荐同时对过敏性鼻炎和哮喘（ARA）进行治疗。但缺少有效评价上、下呼吸道疾病控制情况的工具。
目的：诸多研究对ARA控制情况的检测（CARAT）已设计有问卷调查表，本文对已有的研究进行描述性研究。
方法：通过文献检索，寻找评价ARA控制情况的潜在重要指标，形成列表。正式的问卷调查表形成过程中有111名ARA相关专家和60名患者参与，形成的调查表也创新性的在网络进行应用。最后的定稿会上，25名初级和二级保健医生指定了25个问题并给出了相关选项。其后在31名患者中进行定性的可行性研究，评价问卷调查表的可理解性，期间采用两份不同的设计问卷表。
结果：从中选出34项潜在的重要指标。整个问卷调查表在2.5月内完成。专家和患者意见形成17个问题。可行性研究中，对指导语和措辞进行了纠正，同时式样采用半表格式。
结论：我们采用综合性方法设计形成一项评价ARA控制的问卷调查表，确保了其设计的质量以及形式和内容的有效性。目前，已经开始对其在心理特性上的有效性进行检测。
（林江涛 审校）
Nogueira-Silva L, et al. Respir Res. 2009 Jun 17;10(1):52. [Epub ahead of print]
Control of Allergic Rhinitis and Asthma Test - a formal approach to the development of a measuring tool.
Nogueira-Silva L, Martins SV, Cruz-Correia R, Azevedo LF, Morais-Almeida M, Bugalho-Almeida A, Vaz M, Costa-Pereira A, Fonseca JA.
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.
Aim: 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.
CONCLUSION: 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.
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新型哮喘生物标志物：趋化因子和类几丁质酶蛋白
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成人哮喘患者对支气管扩张剂的反应性不能预测支气管高反应性
