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Background: High atopy prevalence has been reported in athletes. Having an age‐specific questionnaire for predicting atopy is important for an optimal management of young athletes. The study objectives were as follows: (i) developing a scoring system for the Pediatric Allergy Questionnaire for Athletes (AQUAped); (ii) identifying the optimal age target within the range 7‐14 years; (iii) assessing AQUAped validity and repeatability in the identified target population. Methods: A total of 133 young athletes (age 7‐14 years) were recruited. Following a screening visit, the participants filled AQUAped at baseline (T0) and after 7 days (T1), concomitantly undergoing skin prick testing. Using atopy as the gold standard (positivity to ≥1 aeroallergen), the 12 core items were scored based on their likelihood ratios, and a total score was calculated. The optimal cut‐off was identified based on the Youden's criterion. The repeatability of AQUAped was assessed through the intra‐cluster correlation coefficient (ICC). The optimal age target was identified as the largest age range associated with an acceptable cross‐validated area under the receiver operating characteristic curve (AUC ≥ 0.70) and an excellent ICC (≥0.75). Results: Forty (30%) children were atopic; the optimal age target was 10‐14 years (cross‐validated AUC = 0.70, ICC = 0.81). AQUAped total score ranged from −26 to 75, and only 5% of non‐atopic children had AQUAped ≥ 24. AQUAped ≥ 2 had 82% specificity, 60% sensitivity, and 74% overall accuracy. Conclusion: Developing and testing a scoring system for AQUAped showed that it is a valid and reliable tool for the screening of atopy in young athletes aged 10‐14 years. [ABSTRACT FROM AUTHOR]

Background: The international guideline for urticaria recommends the use of the Urticaria Activity Score 7 (UAS7) and the Chronic Urticaria Quality of Life Questionnaire (CU‐Q2oL) to assess patients with chronic spontaneous urticaria (CSU) for their disease activity and impact on quality of life, respectively. Over the last decade, both tools have been validated in many different languages but not in Arabic. Objective: To validate the Arabic UAS7 and CU‐Q2oL in patients with CSU in Lebanon. Methods: After a structured translation process of both instruments into Arabic, their construct and known‐groups validity as well as internal consistency reliability were tested in a longitudinal prospective study using a cluster sample of 152 Lebanese CSU patients. The study also included a repetitive administration of both instruments in 2‐week intervals in 44 patients in order to assess their test‐retest reliability. Results: Both the Arabic UAS7 and CU‐Q2oL demonstrated high internal consistency (Cronbach alpha of 0.95 and 0.82, respectively) and moderate‐to‐high test‐retest reliability (intraclass coefficient of 0.61 and 0.91, respectively). Exploratory factor analysis of the Arabic CU‐Q2oL revealed five components that explained 81.8% of the total variance. Significant correlations were found between the Arabic CU‐Q2oL and the Dermatology Life Quality Index (DLQI) (r = 0.86) and mild‐to‐moderate correlations between the Arabic UAS7 and CU‐Q2oL (r = 0.52) as well as the DLQI (r = 0.51). Conclusions: Our findings demonstrate that the Arabic versions of the UAS7 and the CU‐Q2oL are valid and reliable patient‐reported outcome measures in patients with CSU in Lebanon. [ABSTRACT FROM AUTHOR]

Background: RhinAsthma Patient Perspective (RAPP) is a short, validated questionnaire for assessing health‐related quality of life (HRQoL) in adult patients with comorbid asthma and rhinitis, while a paediatric version is still not available. Objective: The current study aimed to develop and validate the RAPP‐children questionnaire. Methods: RAPP‐children was derived by combining RhinAsthma‐children subscales into five unique items. At baseline (T0) and after 30 days (T1), 150 children (6‐11 years) with comorbid asthma (predominantly intermittent or mild persistent) and rhinitis were given the following: RAPP‐children, RhinAsthma‐children, Paediatric Asthma Quality of Life Questionnaire (PAQLQ, age >6 years), Paediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ), Childhood Asthma Control Test (CACT), KiddyKindl® (age 6 years) or KidKindl® (age >6 years), and a Visual Analogue Scale for nasal symptoms (VAS). At the final visit, a Global Rating of Change (GRC) scale was administered. The approved study was registered on the central registration system ClinicalTrials.gov (ID: NCT03276416). Results: RAPP‐children fairly reproduced RhinAsthma‐children scores (concordance correlation coefficients between 0.91 and 0.95). RAPP‐children showed adequate convergent validity (absolute Spearman's rho larger than 0.5 with PAQLQ, PRQLQ, CACT, KiddyKindl/KidKindl, and VAS), internal consistency (Cronbach's alpha > 0.70), repeatability (intra‐cluster correlation coefficient between 0.61 and 0.8) in the presence of clinical stability (GRC = 0), discriminant validity (sensitivity to asthma control status and rhinitis severity), and sensitivity to symptom improvements (GRC > 1). The minimal important difference (MID) was −20. Floor and ceiling effects were minimal. RAPP‐children showed fair usability also in younger children (6‐8 years). Conclusion & Clinical Relevance: RAPP‐children is a valid, five‐item questionnaire for assessing HRQoL in children aged 6 to 11 years with concomitant asthma and rhinitis. Although further investigation is required in moderate and severe asthmatics, this tool can be useful in clinical trials and in routine medical practice for improving the management of respiratory allergy in children. [ABSTRACT FROM AUTHOR]

Chronic spontaneous urticaria (CSU) is a common skin disorder characterized by the sudden appearance of pruritic wheals, angioedema or both, for a period of at least 6 weeks.[1] CSU is typically associated with a high impact on patients' Health Related Quality of Life (HRQoL)[2] and needs to be treated effectively.[1] Despite the improvement of CSU pharmacotherapy over recent years, many patients have an unsatisfactory response to the currently available drugs. The EAACI/GA SP 2 sp LEN/EDF/WAO guideline for urticaria[1] recommends the use of CU-Q2oL for assessing disease impairment and monitoring response to treatment. Therefore, it is important to understand how changes CU-Q2oL scores are linked to changes in HRQoL impairment and how to interpret the clinical relevance of changes in CU-Q2oL scores associated with disease variability and treatment responses.[[7]]. [Extracted from the article]

A letter to the editor is presented on the "RHINASTHMA-Children," a questionnaire that measures the health-related quality-of-life (HRQoL) of children with respiratory allergy.

Background Specific instruments for health-related quality of life ( HRQoL) assessment in adolescents with rhinoconjunctivitis or asthma are available. None of them evaluates rhinitis and asthma together, although they often coexist. Our aim was to validate a HRQoL questionnaire for adolescents with rhinoconjunctivitis, asthma, or both. Methods A pool of 38 items covering the main symptoms and problems related to respiratory allergy was generated based on literature review, clinical experience, and unstructured interviews to 54 adolescents. The items were randomly listed and presented to 88 consecutive outpatients (44 M; mean age 15.2 ± 3.1). Patients had to indicate which item they had experienced and, for each selected item, its importance on a four-point scale (1 = not at all; 4 = very much). Twelve items were excluded from the list, because of low importance. In the validation phase, 102 patients (54 M; mean age 15.36 ± 1.12) completed the KINDL, a generic HRQoL tool, and the new questionnaire ( RHINASTHMA-Adolescents). Results Factor analysis revealed a five-dimensional structure, which explained up to 71.23% of the total variance. Association between RHINASTHMA-Adolescents and KINDL scores was all in the expected direction. Internal consistency for the extracted factors was satisfactory: Upper Airways (0.81), Lower Airways (0.89), Emotions (0.85), Social Relationship (0.79), Daily life management (0.74). Reliability was good for all factors with a Pearson coefficient ranged from 0.91 to 0.99. Conclusions RHINASTHMA-Adolescents is the first tool for evaluating HRQoL in patients with rhinitis and/or asthma. It provides a simple assessment and met the standards of validity, internal consistency, and reliability. [ABSTRACT FROM AUTHOR]

This summary discusses two articles related to the measurement of quality of life in individuals with Hymenoptera venom allergy (HVA). The first article explores the need for a minimal clinically important difference (MCID) for the Vespid Quality of Life Questionnaire (VQLQ) and suggests a formal MCID of 0.1 for increased accuracy. The second article focuses on the development of a quality-of-life scale specifically for children with HVA. Both articles provide valuable insights into the measurement of quality of life in different contexts, which can be useful for researchers and individuals interested in understanding the impact of HVA on individuals' well-being. [Extracted from the article]

To cite this article: Cazzavillan A, Castelnuovo P, Berlucchi M, Baiardini I, Franzetti A, Nicolai P, Gallo S, Passalacqua G. Management of chronic rhinosinusitis in children. Pediatr Allergy Immunol 2012: 23 (Suppl. 22): 32-44. Abstract Chronic rhinosinusitis (CRS) in children is difficult to treat, with resultant frequent recurrences and failures. There are controversies in the treatment, mirroring the debate over the exact etiology of this disorder. The available medical treatments are antibiotics, topical nasal corticosteroids, and nasal lavage with saline solutions; though, there is no general agreement on the efficacy of the latter. The new technique of balloon sinuplasty allows ventilation to the sinuses to be restored with minimal risk and trauma to the tissues, and initial outcome seems promising, being successful in most treated children. Concerning the surgical approach, adenoidectomy is among the most frequent surgical procedures performed on children, but its therapeutic effect is controversial, because randomized studies have failed to prove that adenoidectomy alone is sufficient in curing CRS. Instead, functional endoscopic sinus surgery is a minimally invasive technique which restores the sinus ostia patency and can re-establish ventilation and drainage through the natural pathways. It is important that the effectiveness of any treatment is also evaluated by patient-reported outcomes (PROs) that refer to all health-related reports coming from the patients, without any involvement or interpretations by physician or others. Among PROs, health-related quality of life (HRQL) is the one most widely known and used. HRQL can be measured by means of validated questionnaires, which provide scores proportional to the degree of well-being perceived by patients. Concerning diseases of the upper airway including RS, there are numerous instruments specifically designed for children and caregivers, which allow to assess the effects of treatments in a more extensive and complete manner. [ABSTRACT FROM AUTHOR]