The modification, translation, and validation of the Malaysian version of Score for Allergic Rhinitis (SFAR) questionnaire

Abstract

Background: Score for Allergic Rhinitis (SFAR) is a validated self-administered questionnaire to assess for allergic rhinitis (AR) in a population setting but was designed for a temperate climate. Objective: This study aims to modify the SFAR for the tropical climate, translate the modified SFAR from English to Malay Language, and validate this Malaysian version of SFAR (MySFAR). Methods: This was a cross-sectional study at an outpatient Otorhinolaryngology clinic in a tertiary center. There were 2 phases in the study: (1) the translation and validation of SFAR and (2) the testing of diagnostic accuracy. Two different groups of participants were recruited for the respective phase. Results: In phase 1, the total MySFAR score showed good discriminant validity between AR and healthy controls (13.44 ± 1.58 v 1.00 ± 2.12, p < 0.01). The internal consistency and test–retest reliability of MySFAR was excellent with Cronbach’s alpha 0.92 (95% CI 0.90–0.94) and intraclass correlation coefficient of 0.97, p < 0.01. In phase 2, MySFAR gave an AUC of 0.98 (95% CI = 0.96–1.00, p < 0.01), and a cut-off score of > 9 (J = 0.92) was determined based on the highest Youden index. This cut-off was 97.8% sensitive and 93.9% specific to predicting allergic rhinitis from non-allergic rhinitis. Conclusion: The present study showed good validity and reliability of MySFAR among the Malaysian population. The cut-off score of > 9 was able to predict allergic rhinitis. This would be a useful screening tool for allergic rhinitis population studies in tropical countries.