Acne severity grading: Determining essential clinical components and features using a Delphi consensus

Tan, Jerry; Wolfe, Barat; Weiss, Jonathan; Stein-Gold, Linda; Bikowski, Joseph; Rosso, James Del; Webster, Guy F.; Lucky, Anne W.; Thiboutot, Diane; Wilkin, Jonathan K.; Leyden, James J.; Chren, Mary Margaret

doi:10.1016/j.jaad.2011.09.005

Cited by 57 publications

(44 citation statements)

References 25 publications

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“…The Delphi process is an egalitarian method of establishing expert consensus on complex issues. It has previously demonstrated usefulness in health care and other industries and is considered a robust method of reaching consensus …”

Section: Methodsmentioning

confidence: 99%

Updating the diagnosis, classification and assessment of rosacea: recommendations from the global ROS acea CO nsensus ( ROSCO ) panel

et al. 2017

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SummaryBackground Rosacea is currently diagnosed by consensus-defined primary and secondary features and managed by subtype. However, individual features (phenotypes) can span multiple subtypes, which has implications for clinical practice and research. Adopting a phenotype-led approach may facilitate patient-centred management. Objectives To advance clinical practice by obtaining international consensus to establish a phenotype-led rosacea diagnosis and classification scheme with global representation. Methods Seventeen dermatologists and three ophthalmologists used a modified Delphi approach to reach consensus on statements pertaining to critical aspects of rosacea diagnosis, classification and severity evaluation. All voting was electronic and blinded. Results Consensus was achieved for transitioning to a phenotype-based approach to rosacea diagnosis and classification. The following two features were independently considered diagnostic for rosacea: (i) persistent, centrofacial erythema associated with periodic intensification; and (ii) phymatous changes. Flushing, telangiectasia, inflammatory lesions and ocular manifestations were not considered to be individually diagnostic. The panel reached agreement on dimensions for phenotype severity measures and established the importance of assessing the patient burden of rosacea. Conclusions The panel recommended an approach for diagnosis and classification of rosacea based on disease phenotype.

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Section: Methodsmentioning

confidence: 99%

Updating the diagnosis, classification and assessment of rosacea: recommendations from the global ROS acea CO nsensus ( ROSCO ) panel

et al. 2017

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“…For the measures properly developed and validated, universal agreement on the best instruments to use has not been reached. Work to date includes identification of essential components and features of global acne scales and an analysis of existing scales in 2013 …”

Section: Current Approaches Used To Assess Efficacy In Acne Clinical mentioning

confidence: 99%

“…Work to date includes identification of essential components and features of global acne scales and an analysis of existing scales in 2013. 19,20 Acne lesion counting is fraught with variability among investigators. 21 As such, large sample sizes (numbers of patients) are needed to overcome this variability, which in turn drives up the cost of the clinical trial.…”

Section: Current Approaches Used To Assess Efficacy In Acne Clinical mentioning

confidence: 99%

Assessing effectiveness in acne clinical trials: steps towards a core outcome measure set

et al. 2019

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Summary Background Acne ranks second to dermatitis in terms of global burden of skin disease. As such, it is essential that data on treatment efficacy are generated in a way that maximizes the opportunity for comparison among treatments. Interest in developing core outcome sets for use in clinical trials to standardize data collection in skin disease is surging. Objectives The goal of this review is to provide an update on the efforts underway, challenges encountered and future directions in the development of an acne core outcome measure set for use in clinical trials. Methods The activities of the Acne Core Outcomes Research Network (ACORN) are presented in the context of currently acceptable methodologies for core outcome set development. Conclusions Emphasis is placed on following a rigorous methodology, involving patients and recognizing a role for emerging technologies.

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“…We followed NICE guidance that grades strength of recommendation using the system Grading of Recommendations Assessment, Development and Evaluation (GRADE) [22]. The grading we adopted took into consideration the median ratings per item, and the interquartile ranges (IQRs) to reflect the levels of variability and therefore of opinion as demonstrated in earlier studies [14,23]. The criteria for determining grading were decided post hoc after statements had been distributed and are shown in Table 1.…”

Section: Clinical Guidelinesmentioning

confidence: 99%

Developing clinical practice guidelines for Chinese herbal treatment of polycystic ovary syndrome: A mixed-methods modified Delphi study

Lai¹,

Flower²,

Moore³

et al. 2015

Complementary Therapies in Medicine

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SummaryObjectives: Preliminary evidence suggests Chinese herbal medicine (CHM) could be a viable treatment option for polycystic ovary syndrome (PCOS). Prior to conducting a clinical trial it is important to consider the characteristics of good clinical practice. This study aims to use professional consensus to establish good clinical practice guidelines for the CHM treatment of PCOS. Design and setting: CHM practitioners participated in a mixed-methods modified Delphi study involving three rounds of structured group communication. Round 1 involved qualitative interviews with practitioners to generate statements regarding good clinical practice. In round 2, these statements were distributed online to the same practitioners to rate their agreement using a 7-point Likert scale, where group consensus was defined as a median rating of ≥5. Statements reaching consensus were accepted for consideration onto the guideline whilst those not reaching consensus were re-distributed for consideration in round 3. Statements presented in the guidelines were graded from A (strong consensus) to D (no consensus) determined by median score and interquartile range. Results: 11 CHM practitioners in the UK were recruited. After three Delphi rounds, 91 statement items in total had been considered, of which 89 (97.8%) reached consensus and 2 (2.2%) did not. The concluding set of guidelines consists of 85 items representing key features of CHM prescribing for PCOS. Conclusions: These guidelines can be viewed as an initial framework that captures fundamental principles of good clinical practice for CHM.

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Acne severity grading: Determining essential clinical components and features using a Delphi consensus

Cited by 57 publications

References 25 publications

Updating the diagnosis, classification and assessment of rosacea: recommendations from the global ROS acea CO nsensus ( ROSCO ) panel

Updating the diagnosis, classification and assessment of rosacea: recommendations from the global ROS acea CO nsensus ( ROSCO ) panel

Assessing effectiveness in acne clinical trials: steps towards a core outcome measure set

Developing clinical practice guidelines for Chinese herbal treatment of polycystic ovary syndrome: A mixed-methods modified Delphi study

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