Background: There is no internationally recognized outcome measure for the assessment of acute respiratory tract infections (ARTIs) in children. The only identifiable scale initially developed for pediatric application has been the Canadian acute respiratory illness and flu scale (CARIFS). The aim of our trial was to adapt the English version of the CARIFS to the Ukrainian language.
Materials and methods: We performed forward and backward translation of the original version of the CARIFS according to the recommended standard. Then, the final CARIFS-based Ukrainian questionnaires were given to 149 caregivers whose 3-12 years old children suffered from ARTI. The questionnaires were completed twice by a caregiver 3-6 hours apart and once by a physician just after the second completion by a caregiver. The database was analyzed to assess the consistency (the Cronbach's α coefficient), sensitivity (the standardized response mean; the effect size), reliability (test-retest analysis), and validity (Pearson's correlation) of the CARIFS in the Ukrainian language.
Results: The backward translation of the Ukrainian version of the CARIFS demonstrated its good correspondence to the English version. The Cronbach's α coefficient was 0.805, and item to total correlation coefficients varied from 0.185 to 0.665. The standardized response mean was 1.73, and the effect size was 2.50 suggesting good sensitivity of the scale. In the test-retest reliability analysis of 99 questionnaires, the median CARIFS score for the first and the second measurement was 19.0 (interquartile range [IQR]: 14.5-25.0) and 19.0 (IQR: 15.0-25.0), respectively, with a median change of 0.0 (IQR: -1.0 to 0.0, P=0.996). The Pearson's correlation coefficient between the CARIFS score completed by a responder and a physician was 0.832 (P=0.004).
Conclusion: The Ukrainian version of the CARIFS-based English questionnaire proved to be a consistent, sensitive, reliable, and valid instrument in the assessment of ARTI in preschool and elementary school children in the Ukrainian population.
Keywords: acute respiratory infection; children; linguistic validation; patient-related outcomes.