The review analyzed studies on the development, adaptation, and validation of CARATkids. This research performed a comprehensive search across Ovid/MEDLINE, Web of Science, and Scopus, initially in October 2023 and updated in June 2025. Out of 193 search results, 9 studies met the inclusion criteria.
The findings revealed that CARATkids demonstrates sufficient content validity, confirming that the tool captures the children’s experience of asthma and allergic rhinitis symptoms. Also, its internal consistency was strong, with a meta-analytical Cronbach alpha of 0.81 (95% CI = 0.79–0.83). This indicated that the items within the test are well-correlated and measure the same underlying construct.
A pooled intraclass correlation coefficient (ICC) of 0.86 (95% CI = 0.61–0.96) demonstrates the stability of the test over time. Moreover, the minimal clinically important difference (MCID) was found to be 2.76 points, which provided a benchmark to interpret changes in a child’s score. Construct validity, which examines whether CARATkids correlates with related outcome measures, also showed promising results.
The meta-analysis found absolute Spearman coefficients ranging from 0.37 to 0.71, which suggested moderate to strong correlations. This means CARATkids aligns well with other validated instruments that measure similar health outcomes. The review showed that CARATkids correlated well with changes captured by other outcome measures, confirming its usefulness in both clinical monitoring and research.
Overall, the synthesis of these results highlights CARATkids as a valuable PROM for pediatric patients managing both asthma and allergic rhinitis. Given that these conditions often coexist, a single tool capable of measuring their combined impact offers a more holistic view of a child’s health status, reducing the need for multiple questionnaires.
Source:
El Didi, H. S., Pereira, A. M., Jácome, C., Amaral, R., Wandalsen, G. F., Emons, J., La Grutta, S., Cilluffo, G., Batmaz, S. B., Linhares, D., Sole, D., Sousa-Pinto, B., Fonseca, J. A., & Vieira, R. J. (2025). Control of Allergic Rhinitis and Asthma Test for Children (CARATkids): A systematic review and meta-analysis of its measurement properties. Pediatric Allergy and Immunology: Official Publication of the European Society of Pediatric Allergy and Immunology, 36(9), e70191. https://doi.org/10.1111/pai.70191
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