Validation and reproducibility of the International Study of Asthma and Allergies in Childhood (ISAAC) Written Allergic Rhinitis Questionnaire for phone survey in children aged 6‒7 years

Priscilla Campos; Solange O R Valle; Antônio José Ledo Alves da Cunha; Fábio Chigres Kuschnir; Dirceu Solé

doi:10.1016/j.bjorl.2024.101531

Validation and reproducibility of the International Study of Asthma and Allergies in Childhood (ISAAC) Written Allergic Rhinitis Questionnaire for phone survey in children aged 6‒7 years

Braz J Otorhinolaryngol. 2024 Nov 19;91(2):101531. doi: 10.1016/j.bjorl.2024.101531. Online ahead of print.

Authors

Priscilla Campos¹, Solange O R Valle², Antônio José Ledo Alves da Cunha³, Fábio Chigres Kuschnir⁴, Dirceu Solé⁵

Affiliations

¹ Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ, Brazil. Electronic address: pricampos290@gmail.com.
² Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ, Brazil.
³ Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Rio de Janeiro, RJ, Brazil.
⁴ Universidade do Estado do Rio de Janeiro (UERJ), Departamento de Pediatria, Rio de Janeiro, RJ, Brazil.
⁵ Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil.

Abstract

Objective: To validate and assess the reproducibility of the ISAAC Written Allergic Rhinitis Questionnaire (WARQ) for children aged between 6 and 7 years by telephone contact.

Methods: Observational study through interviews with guardians of children aged 6-7 years using the ISAAC Allergic Rhinitis (AR) module questionnaire in three different phases separated by 2 weeks each: telephone interviews in the first and third contacts and face-to-face interviews, with the same guardian of telephone interviews, in the second contact. Reproducibility was estimated using the Kappa index and validation using the sensitivity and specificity coefficients.

Results: Data from 94 children (48 from the allergic rhinitis Control Group ‒ CG) were analyzed. Reproducibility showed perfect agreement (100%) for the question number 1 - Which refers to the symptoms of AR, ever: "Has your child ever had a problem with sneezing or a runny or a blocked nose when he/she did not have a cold or the flu?" and for the question number 2 - Which refers to current symptoms of AR: "In the past 12 months, has your child had a problem with sneezing or a runny or a blocked nose when he/she did not have a cold or the flu?" A strong agreement was also observed for the question number 3 (κ = 0.871) - it defines the presence of comorbidity of allergic rhinoconjuntivitis "In the past 12 months, has this nose problem been accompanied by itchy-watery eyes?" The validation showed high specificity (≥76.7%) and sensitivity (≥98%) for all questions, except for the ones related to seasonality and intensity of symptoms.

Conclusions: Our results showed that the ISAAC AR module questionnaire by telephone interviews has good reproducibility and high agreement with the clinical diagnosis of AR. It may be an appropriate alternative tool in epidemiological studies of childhood AR, especially in periods of social isolation, such as Coronavirus pandemic.

Level of evidence: Cohort Study.

Keywords: Allergic rhinitis; Epidemiology; Reproducibility; Telephone interview; Validity.