Canadian Acute Respiratory Illness and Flu Scale (CARIFS) Development of a valid measure for childhood respiratory infections

Jacobs, Benjamin; Young, Nancy L; Dick, Paul T; Ipp, Moshe M; Dutkowski, Regina; Davies, H.Dele; Langley, Joanne M; Greenberg, Saul; Stephens, Derek; Wang, Elaine E.L

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Volume 53, Issue 8 , Pages 793-799, August 2000

Canadian Acute Respiratory Illness and Flu Scale (CARIFS)

Development of a valid measure for childhood respiratory infections

Benjamin Jacobs
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Nancy L Young
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Paediatric Outcomes Research Team, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Paul T Dick
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Paediatric Outcomes Research Team, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Moshe M Ipp
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Regina Dutkowski
- Department of Clinical Sciences, Hoffmann-La Roche, Nutley, NJ, USA
H.Dele Davies
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
Joanne M Langley
- Department of Paediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
Saul Greenberg
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Derek Stephens
- Clinical Epidemiology Unit, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Elaine E.L Wang
- Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Clinical Epidemiology Unit, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Corresponding author. Vice President, Clinical and Medical Affairs, Aventis Pasteur-Connaught Campus, 1755 Steeles Avenue West, Toronto, Ontario, M2R 3T4, Canada. Tel: 416–667–2476; fax: 416–667–2939.

Received 7 July 1999; accepted 22 December 1999.

Abstract

Although acute respiratory infection (ARI) is the most frequent clinical syndrome in childhood, there is no validated measure of its severity. Therefore a parental questionnaire was developed: the Canadian Acute Respiratory Illness Flu Scale (CARIFS). A process of item generation, item reduction, and scale construction resulted in a scale composed of 18 items covering three domains; symptoms (e.g., cough); function (e.g., play), and parental impact (e.g., clinginess). The validity of the scale was evaluated in a study of 220 children with ARI. Construct validity was assessed by comparing the CARIFS score with physician, nurse, and parental assessment of the child's health. Data were available from 206 children (94%). The CARIFS correlated well with measures of the construct (Spearman's correlations between 0.36 and 0.52). Responsiveness was shown, with 90% of children having a CARIFS score less than a quarter of its initial value, by the tenth day.

Keywords: Acute respiratory infection, Severity of illness index, Outcome assessment, Pediatrics, Outpatients, Questionnaires