Original Article
 

Evaluation of the Reliability and Validity of the Persian Version of Urticaria Control Test (UCT)

Abstract

The urticaria control test (UCT) is a patient-reported outcome measure (PROM) for chronic urticaria (CU) patients. As a Persian version of the UCT was not available, the present research aimed to develop such a version, to test its reliability and validity as well as to evaluate urticaria control among Persian-speaking patients.
This research was conducted at the Urticaria Centre of Reference and Excellence (UCARE) of Ghaem Hospital, Mashhad, Iran. In a first step, a linguistically validated Persian version of the UCT was developed through a structured forward and backward translation process and subsequent cognitive debriefing interviews. In a second step, the Persian version of the UCT was completed by 100 well-characterized CU patients together with two anchor instruments, the Chronic Urticaria Quality of life Questionnaire (CU-Q2oL) and the urticaria activity score (UAS), to obtain information on its internal consistency reliability and convergent validity.
The Persian version of the UCT was found to have acceptable internal consistency reliability with a Cronbach's alpha coefficient of 0.68. In addition, the results obtained with the Persian UCT correlated with the CU-Q2oL total score (-0.48, p<0.001) and the UAS (-0.404, p˂0.001), suggesting convergent validity. Virtually all patients had poorly controlled CU (UCT<12).
A Persian version of the UCT is now available and may help to improve the assessment and monitoring of disease control in Persian-speaking CU patients and to optimize treatment decisions.

1. Gonçalo M, Gimenéz-Arnau A, Al-Ahmad M, Ben-Shoshan M, Bernstein JA, Ensina LF, et al. The global burden of chronic urticaria for the patient and society. Br J Dermatol. 2021;184(2):226-36.
2. Zuberbier T, Aberer W, Asero R, Bindslev‐Jensen C, Brzoza Z, Canonica GW, et al. The EAACI/GA 2 LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy. 2014;69(7):868-87.
3. Greaves M. Chronic urticaria. J Allergy Clin Immunol. 2000;105(4):664-72.
4. Weller K, Siebenhaar F, Hawro T, Altrichter S, Schoepke N, Maurer M. Clinical measures of chronic urticaria. Immunol Allergy Clin North Am. 2017;37(1):35-49.
5. Weller K, Zuberbier T, Maurer M. Clinically relevant outcome measures for assessing disease activity, disease control and quality of life impairment in patients with chronic spontaneous urticaria and recurrent angioedema. Curr Opin Allergy Clin Immunol. 2015;15(3):220-6.
6. Jariwala SP, Moday H, De Asis ML, Fodeman J, Hudes G, De Vos G, et al. The Urticaria Severity Score: a sensitive questionnaire/index for monitoring response to therapy in patients with chronic urticaria. Ann Allergy. 2009;102(6):475-82.
7. Jáuregui I, Ortiz de Frutos F, Ferrer M, Giménez-Arnau A, Sastre J, Bartra J, et al. Assessment of severity and quality of life in chronic urticaria. J Investig Allergol Clin Immunol. 2014;24(2):80-6.
8. Weller K, Groffik A, Church MK, Hawro T, Krause K, Metz M, et al. Development and validation of the Urticaria Control Test: a patient-reported outcome instrument for assessing urticaria control. J Allergy Clin Immunol. 2014;133(5):1365-72.
9. Zuberbier T, Aberer W, Asero R, Abdul Latiff AH, Baker D, Ballmer‐Weber B, et al. The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria. Allergy. 2018;73(7):1393-414.
10. Maurer M, Metz M, Bindslev‐Jensen C, Bousquet J, Canonica GW, Church MK, et al. Definition, aims, and implementation of GA2LEN urticaria centers of reference and excellence. Allergy. 2016;71(8):1210-8.
11. Kulthanan K, Chularojanamontri L, Tuchinda P, Rujitharanawong C, Maurer M, Weller K. Validity, reliability and interpretability of the Thai version of the urticaria control test (UCT). Health Qual Life Outcomes. 2016;14(1):61-6.
12. George D, Mallery M. Using SPSS for Windows step by step: a simple guide and reference. 2003.
13. Nunnally JC. Psychometric theory 3E: Tata Mc Graw-Hill Education; 1994.
14. Tavakol M, Mohammadinejad P, Baiardini I, Braido F, Gharagozlou M, Aghamohammadi A, et al. The persian version of the chronic urticaria quality of life questionnaire: factor analysis, validation, and initial clinical findings. Iran J Allergy Asthma Immunol. 2014; 13(4):278-85.
15. Hawro T, Ohanyan T, Schoepke N, Metz M, Peveling-Oberhag A, Staubach P, et al. The Urticaria Activity Score—validity, reliability, and responsiveness. J Allergy Clin Immunol Pract. 2018;6(4):1185-90.
16. Black K. The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria. Br J Dermatol. 1999;140(3):446-52.
17. Baiardini I, Pasquali M, Braido F, Fumagalli F, Guerra L, Compalati E, et al. A new tool to evaluate the impact of chronic urticaria on quality of life: chronic urticaria quality of life questionnaire (CU‐Q2oL). Allergy. 2005;60(8):1073-8.
18. Khan DA. Chronic urticaria: diagnosis and management. Allergy and asthma proceedings. 2008;29(5):439-46.
19. Ye Y-M, Kim S-C, Ban G-Y, Shin Y-S, Park H-S. Adaptation and Validation of the Korean Version of Urticaria Control Test. J Allergy Clin Immunol. 2017;139(2):AB245.
20. Maurer M, Weller K, Bindslev‐Jensen C, Giménez‐Arnau A, Bousquet P, Bousquet J, et al. Unmet clinical needs in chronic spontaneous urticaria. A GA2LEN task force report 1. Allergy. 2011;66(3):317-30.
21. Młynek A, Zalewska‐Janowska A, Martus P, Staubach P, Zuberbier T, Maurer M. How to assess disease activity in patients with chronic urticaria? Allergy. 2008;63(6):777-80.
22. Axelrod S, Davis‐Lorton M. Urticaria and angioedema. Mt Sinai J Med. 2011;78(5):784-802.
23. Kaplan AP. Chronic urticaria: pathogenesis and treatment. J Allergy Clin Immunol. 2004;114(3):465-74.
24. Grattan C, Wallington T, Warin R, Kennedy C, Lbradfield J. A serological mediator in chronic idiopathic urticaria—a clinical, immunological and histological evaluation. Br J Dermatol. 1986;114(5):583-90.
25. Guttman‐Yassky E, Bergman R, Maor C, Mamorsky M, Pollack S, Shahar E. The autologous serum skin test in a cohort of chronic idiopathic urticaria patients compared to respiratory allergy patients and healthy individuals. J Eur Acad Dermatol Venereol. 2007;21(1):35-9.
26. Irani C, Hallit S, Weller K, Maurer M, El Haber C, Salameh P. Chronic urticaria in most patients is poorly controlled: results of the development, validation, and real life application of the Arabic urticaria control test. Saudi Med J. 2017;38(12):1230.
27. Nakatani S, Oda Y, Washio K, Fukunaga A, Nishigori C. The Urticaria Control Test and Urticaria Activity Score correlate with quality of life in adult Japanese patients with chronic spontaneous urticaria. Allergol Int. 2019;68(2):279-81.
28. Fadaee J, Khoshkhui M, Emadzadeh M, Hashemy SI, Hosseini RF, Azad FJ, et al. Evaluation of Serum Substance P Level in Chronic Urticaria and Correlation with Disease Severity. Iran J Allergy Asthma Immunol. 2019(4):1-9.
29. Zabolinejad N, Molkara S, Bakhshodeh B, Ghaffari-Nazari H, Khoshkhui M. The expression of serotonin transporter protein in the skin of patients with chronic spontaneous urticaria and its relation with depression and anxiety. Arc Dermatol Res. 2019;311(10):825-31.
30. Maurer M, Costa C, Gimenez Arnau A, Guillet G, Labrador‐Horrillo M, Lapeere H, et al. Antihistamine‐resistant chronic spontaneous urticaria remains undertreated: 2‐year data from the AWARE study. Clin Exp Allergy. 2020;50(10):1166-1175.
31. Maurer M, Giménez-Arnau A, Ensina LF, Chu C-Y, Jaumont X, Tassinari P. Chronic urticaria treatment patterns and changes in quality of life: AWARE study 2-year results. World Allergy Organ J. 2020;13(9):100460.
Files
IssueVol 20 No 4 (2021) QRcode
SectionOriginal Article(s)
Published2021-08-07
DOI https://doi.org/10.18502/ijaai.v20i4.6952
Keywords
Chronic urticaria Patient reported outcome measures Quality of life Reproducibility of results

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Khoshkhui M, Weller K, Fadaee J, Maurer M, Jabbari Azad F, Emadzadeh M. Evaluation of the Reliability and Validity of the Persian Version of Urticaria Control Test (UCT). Iran J Allergy Asthma Immunol. 2021;20(4):423-431.