Validity and repeatability of the Pediatric Allergy Questionnaire for Athletes (AQUAped) for the screening of atopy

Background High atopy prevalence has been reported in athletes. Having an age-specific questionnaire for predicting atopy is important for an optimal management of young athletes. The study objectives were: i) developing a scoring system for the Pediatric Allergy Questionnaire for Athletes (AQUAped); ii) identifying the optimal age target within the range 7-14 years; iii) assessing AQUAped validity and repeatability in the identified target population. Methods A total of 133 young athletes (age 7-14 years) were recruited. Following a screening visit, the participants filled AQUAped at baseline (T0) and after 7 days (T1), concomitantly undergoing skin prick testing. Using atopy as the gold standard (positivity to >=1 aeroallergen), the 12 core items were scored based on their likelihood ratios, and a total score was calculated. The optimal cut-off was identified based on the Youden's criterion. The repeatability of AQUAped was assessed through the intra-cluster correlation coefficient (ICC). The optimal age target was identified as the largest age range associated with an acceptable cross-validated area under the receiver operating characteristic curve (AUC>=0.70) and an excellent ICC (>=0.75). Results Forty (30%) children were atopic; the optimal age target was 10-14 years (cross-validated AUC=0.70, ICC=0.81). AQUAped total score ranged from -26 to 75, and only 5% of non atopic children had AQUAped>=24. AQUAped>=2 had 82% specificity, 60% sensitivity, and 74% overall accuracy. Conclusion Developing and testing a scoring system for AQUAped showed that it is a valid and reliable tool for the screening of atopy in young athletes aged 10 to 14 years.