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Vol. 48. Issue 2.
Pages 165-169 (March - April 2020)
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Vol. 48. Issue 2.
Pages 165-169 (March - April 2020)
Original Article
DOI: 10.1016/j.aller.2019.07.006
Cross-cultural adaptation and validation of the RhinAsthma Patient Perspective (RAPP) in Spanish
I.J. Ansoteguia, F. Braidob, G. Molinengoc,
Corresponding author

Corresponding author.
, B. Loerac, S. Gonzalez-Diazd, M. Sanchez-Borgese, G.W. Canonicaf, I. Baiardinib,f
a Department of Allergy and Immunology. Hospital Quironsalud Bizkaia, Bilbao, Spain
b Department of Internal Medicine, Respiratory Diseases and Allergy Clinic, University of Genova - Azienda Policlinico IRCCs San Martino, Genova, Italy
c Department of Psychology, University of Turin, Turin, Italy
d Universidad Autónoma de Nuevo León, Hospital Universitario Dr. José Eleuterio González, Centro Regional de Alergia e Inmunología Clínica, Monterrey, Mexico
e Deaprtment of Allergy and Clinical Immunology, Centro Médico Docente La Trinidad and Clínica El Avila, Caracas, Venezuela
f Personalized Medicine, Asthma and Allergy Clinic, Humanitas Research Hospital, Milan, Italy
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Figures (1)
Tables (2)
Table 1. RAPP discriminant validity (means and standard deviation).
Table 2. The minimal important difference (MID) of RAPP obtained with the ROC analysis with different cut-offs.
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the RhinAsthma Patient Perspective (RAPP) is the only available tool to assess HRQoL in daily practice. The aim of this study is to cross-culturally validate the RAPP in Spanish.


The RAPP was translated into Spanish. Adult patients receiving usual care for asthma and allergic rhinitis (AR) were recruited consecutively and assessed twice with a four-week interval between visits to test the psychometric properties of the questionnaire.


149 patients (62.8% female) with a mean age of 37.7 years completed the study. Exploratory and confirmatory factor analysis confirmed the uni-dimensional structure of the questionnaire. Internal consistency (0.73 at visit 1; 0.87 at visit 2), convergent and discriminant validity (p<.05 at both visits) were satisfactory. Reliability was confirmed by an ICC of 0.69 and a CCC of 0.74. Responsiveness was supported by a significant association with VAS (r=0.28, p<0.003) and ACT (r=−0.35, p<0.01). The minimal clinical difference (MID) value in the analyzed population was 2.


The Spanish version of RAPP was demonstrated to have satisfactory psychometric properties and is a valid, reliable and responsive tool for the assessment of asthma and AR HRQoL in clinical practice.

Allergic rhinitis
Clinical practice
Health related quality of life
Validation study


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