Study: Validation of Patient-Reported Global Severity of AD in Adults
Atopic dermatitis (AD) is associated with a heterogeneous presentation and clinical course. However, there is a lack of simple and validated severity assessments that are feasible for clinical practice and epidemiological research, according to researchers of a new study that sought to validate patient-reported global AD severity in adults. The researchers performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n=265).
At baseline and follow-up, patient-reported global AD severity significantly correlated with objective-SCORing Atopic Dermatitis (oSCORAD; Spearman rho=0.56 and 0.49), SCORing Atopic Dermatitis (SCORAD; 0.64 and 0.56), Eczema Area and Severity Index (EASI; 0.56 and 0.50), body surface area (BSA; 0.52 and 0.45), Itch Numeric Rating System (NRS-itch; 0.60 and 0.53), Patient-Oriented Eczema Measure (POEM; 0.50 and 0.48), and Dermatology Life Quality Index (DLQI; 0.50 and 0.49). Patient-reported moderate and severe AD vs mild AD was associated with significantly higher oSCORAD, SCORAD, EASI, BSA, NRS-itch, POEM, and DLQI (P<.0001 for all).
The study showed that 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).
Patient-reported AD severity appears to be sufficiently valid for assessing AD severity in the clinical and epidemiological setting, the researchers concluded.
Vakharia PP, Chopra R, Sacotte R, et al. Validation of patient-reported global severity of atopic dermatitis in adults [published online September 14, 2017]. Allergy. doi:10.1111/all.1330