Validity, reliability, and responsiveness of daily monitoring visual analog scales in MASK-air®

Bernardo Sousa-Pinto, Patrik Eklund, Oliver Pfaar, Ludger Klimek, Torsten Zuberbier, Wienczyslawa Czarlewski, Annabelle Bédard, Carsten Bindslev-Jensen, Anna Bedbrook, Sinthia Bosnic-Anticevich, Luisa Brussino, Victoria Cardona, Alvaro A. Cruz, Govert de Vries, Philippe Devillier, Wytske J. Fokkens, José Miguel Fuentes-Pérez, Bilun Gemicioğlu, Tari Haahtela, Yunen Rocío Huerta-VillalobosJuan Carlos Ivancevich, Inger Kull, Piotr Kuna, Violeta Kvedariene, Désirée E. Larenas Linnemann, Daniel Laune, Michael Makris, Erik Melén, Mário Morais-Almeida, Ralph Mösges, Joaquim Mullol, Robyn E. O'Hehir, Nikolaos G. Papadopoulos, Ana Margarida Pereira, Emmanuel P. Prokopakis, Fotis Psarros, Frederico S. Regateiro, Sietze Reitsma, Boleslaw Samolinski, Nicola Scichilone, Jane da Silva, Cristiana Stellato, Ana Todo-Bom, Peter Valentin Tomazic, Sanna Toppila Salmi, Antonio Valero, Arunas Valiulis, Erkka Valovirta, Michiel van Eerd, Maria Teresa Ventura, Arzu Yorgancioglu, Xavier Basagaña, Josep M. Antó, Jean Bousquet, João A. Fonseca

Research output: Contribution to journalReview articlepeer-review

33 Citations (Scopus)
26 Downloads (Pure)


Background: MASK-air® is an app that supports allergic rhinitis patients in disease control. Users register daily allergy symptoms and their impact on activities using visual analog scales (VASs). We aimed to assess the concurrent validity, reliability, and responsiveness of these daily VASs. Methods: Daily monitoring VAS data were assessed in MASK-air® users with allergic rhinitis. Concurrent validity was assessed by correlating daily VAS values with those of the EuroQol-5 Dimensions (EQ-5D) VAS, the Control of Allergic Rhinitis and Asthma Test (CARAT) score, and the Work Productivity and Activity Impairment Allergic Specific (WPAI-AS) Questionnaire (work and activity impairment scores). Intra-rater reliability was assessed in users providing multiple daily VASs within the same day. Test–retest reliability was tested in clinically stable users, as defined by the EQ-5D VAS, CARAT, or “VAS Work” (i.e., VAS assessing the impact of allergy on work). Responsiveness was determined in users with two consecutive measurements of EQ-5D-VAS or “VAS Work” indicating clinical change. Results: A total of 17,780 MASK-air® users, with 317,176 VAS days, were assessed. Concurrent validity was moderate–high (Spearman correlation coefficient range: 0.437–0.716). Intra-rater reliability intraclass correlation coefficients (ICCs) ranged between 0.870 (VAS assessing global allergy symptoms) and 0.937 (VAS assessing allergy symptoms on sleep). Test–retest reliability ICCs ranged between 0.604 and 0.878—“VAS Work” and “VAS asthma” presented the highest ICCs. Moderate/large responsiveness effect sizes were observed—the sleep VAS was associated with lower responsiveness, while the global allergy symptoms VAS demonstrated higher responsiveness. Conclusion: In MASK-air®, daily monitoring VASs have high intra-rater reliability and moderate–high validity, reliability, and responsiveness, pointing to a reliable measure of symptom loads.

Original languageEnglish
Article numbere12062
Pages (from-to)1-15
Number of pages15
JournalClinical and Translational Allergy
Issue number7
Publication statusPublished - Aug 2021
Externally publishedYes

Bibliographical note

Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • allergic rhinitis
  • mobile health
  • reliability
  • responsiveness
  • visual analog scales


Dive into the research topics of 'Validity, reliability, and responsiveness of daily monitoring visual analog scales in MASK-air®'. Together they form a unique fingerprint.

Cite this