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Validation of patient‐reported global severity of atopic dermatitis in adults
Author(s) -
Vakharia P. P.,
Chopra R.,
Sacotte R.,
Patel N.,
Immaneni S.,
White T.,
Kantor R.,
Hsu D. Y.,
Silverberg J. I.
Publication year - 2018
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.13309
Subject(s) - scorad , atopic dermatitis , medicine , eczema area and severity index , concordance , severity of illness , quality of life (healthcare) , dermatology , clinical practice , prospective cohort study , dermatology life quality index , disease , physical therapy , nursing
Background Atopic dermatitis ( AD ) is associated with a heterogeneous presentation and clinical course. There is a lack of simple and validated severity assessments that are feasible for clinical practice and epidemiological research. Objectives We sought to validate patient‐reported global AD severity in adults. Methods We performed a prospective dermatology practice‐based study using questionnaires and evaluation by a dermatologist (n = 265). Results At baseline and follow‐up, patient‐reported global AD severity significantly correlated with oSCORAD (Spearman ρ = 0.56 and 0.49), SCORAD (0.64 and 0.56), EASI (0.56 and 0.50), BSA (0.52 and 0.45), NRS ‐itch (0.60 and 0.53), POEM (0.50 and 0.48), and DLQI (0.50 and 0.49) ( P < .0001 for all). Patient‐reported moderate and severe AD vs mild AD were associated with significantly higher oSCORAD , SCORAD , EASI , BSA , NRS ‐itch, POEM , and DLQI ( P < .0001 for all). There was moderate concordance between patient‐reported AD severity (mild, moderate, and severe) and previously developed severity strata for oSCORAD (κ = 0.39), SCORAD (κ = 0.47), EASI (κ = 0.37), NRS ‐itch (κ = 0.49), POEM (κ = 0.37), and DLQI (κ = 0.40). Among patients with severe disease at baseline, those who reported mild or moderate disease on follow‐up had significantly greater absolute reductions of oSCORAD (−23.4/−9.7/−1.8), SCORAD (−33.0/−13.2/−2.3), EASI (−17.1/−9.8/−3.2), BSA (−46%/−15%/−4%), NRS ‐itch (−5/−2/0), POEM (−5/−2/0), and DLQI (−8/−6/−1) than those who continued to report severe disease (Kruskal‐Wallis, P ≤ .0003 for all). Conclusions Patient‐reported AD severity appears to be sufficiently valid for assessing AD severity in the clinical and epidemiological setting.