Testing a quality‐of‐life questionnaire in Dutch people with hand eczema

Hand eczema interferes with many aspects of everyday life. This is an important consideration but such interference is hard to measure. Any scoring system must itself be carefully assessed to make sure it is relevant, reliable and sensitive enough to pick up any meaningful change before and after any new treatment. Doctors in the Netherlands studied the Dutch version of an internationally recognised measurement instrument (system), the Quality Of Life in Hand Eczema Questionnaire (QOLHEQ). This instrument has 30 questions covering symptoms, emotions, functioning and treatment during the past week, with answers on a five‐point scale. They tested it on 300 adults and repeated the test after 3 days and 4‐12 weeks. They also photographed and scored the hand eczema severity and used several other quality of life measures for comparison. QOLHEQ scores from people whose eczema was unchanged after 3 days, according to a global severity score, were used to assess how reproducible this measurement was; and those whose global severity score changed after 3 days to 4‐12 weeks were used to see how sensitive the test was to change. The authors used rigorous statistical tests to check that their findings were sound. They had to adjust the score in some respects and the final version of the Dutch QOLHEQ gave a maximum of 89 points made up of 21 for symptoms, 24 each for emotions and functioning and 20 for treatment. They conclude that the final version is valid, reproducible and responsive. The authors estimate that an improvement of at least 15 points represents a genuine improvement for Dutch patients. Linked Article:   Oosterhaven et al . Br J Dermatol 2020; 183 :86–95.