Cross cultural translation, adaptation and reliability of the Malay version of the Canadian Acute Respiratory Illness and Flu Scale (CARIFS)

Anna Marie Nathan, Rafdzah Zaki, Rachael Rozario, Nurul Dhania, Siti Nur Sabrina Mohd Hamirudin, Kah Peng Eg, Sze Ying Kee, Cindy Teh, Kartini Abdul Jabar, Caroline Westerhout, Surendran Thavagnanam, Jessie de Bruyne

The Canadian Acute Respiratory Illness and Flu Scale (CARIFS) is a parent-proxy questionnaire that assesses severity of acute respiratory infections in children. The aim was to (a) perform a cross-cultural adaptation and (b) prove that the Malay CARIFS is a reliable tool. The CARIFS underwent forward and backward translations as recommended by international guidelines. A pilot study was performed on the harmonised version and the final version of the Malay version of CARIFS was produced. A test-retest, 1 h apart, was then performed on parents with children less than 13 years old, admitted with a respiratory tract infection. Parents of children with asthma and who were not eloquent in Malay, were excluded. The data was analysed for consistency (Cronbach's alpha) and reliability (test-retest co-efficient). Thirty-three parents were recruited. Children were aged median (IQR) 6 (2.8, 13.3) months with a male: female ratio of 22:11 and 88 % were Malays. Parents were interviewed at median (IQR) 6 (3, 11.5) days of admission. The Cronbach's α coefficient was 0.70 for all items. The test-retest reliability analysis had a minimum and maximum intraclass correlation coefficient of 0.63 and 0.97 respectively. Clinically, the longer patients were admitted, the lower the severity score (r = -0.35, p < 0.05), indicating that they were getting better. The Malay version of CARIFS is a valid and reliable tool to determine severity of respiratory illness in children. Parent-centred questionnaires are useful and should be an adjunct to other methods, in monitoring response to treatment.