Clinical experience and psychometric properties of the Cardiff Acne Disability Index (CADI)*

Abstract

The Cardiff Acne Disability Index (CADI) is a questionnaire designed to measure the quality of life of teenagers and young adults with acne. It has been used clinically and within therapeutic research globally. This review aims to appraise all published data regarding the clinical and research experience of the CADI, its psychometric properties and validation, from its publication in 1992 until September 2020, in a single reference source. A literature search was conducted using MEDLINE via Ovid, PubMed, EBSCOhost, Web of Science and Scopus. All full articles in the English language were included. A total of 96 clinical studies were identified and analysed. The CADI has been used in 44 different countries, including four multinational studies, and has validated translations in 25 languages. Overall, 29 therapeutic interventions have used the CADI, demonstrating its responsiveness to change. The reliability of the CADI has been assessed in 14 studies through test-retest and internal consistency studies. In total, 57 studies have demonstrated aspects of its validity through correlation to other measures, and five studies have investigated the dimensionality of the CADI. There is evidence of high internal consistency, test-retest reliability, responsiveness to change and significant correlation with other objective measures. The minimal clinically important difference and validated score meaning bands have not yet been reported. This information is needed to improve the interpretability of CADI scores for clinical use and in research. The authors of the CADI have also rephrased Question 2 of the measure to ensure inclusivity.What is already known about this topic?• Acne significantly impacts quality of life in patients.• There are several skin-specific and acne-specific instruments used in day-to-day practice and research.• The validation and other measurement properties of the Cardiff Acne Disability Index (CADI) have not been easily accessible.What does this study add?• The CADI has been extensively used and is a reliable and valid tool.• There is a need to develop validated CADI score bands and calculate the minimal clinically important difference.• The CADI authors have rephrased Question 2 to ensure that the wording is inclusive.• There is inconsistent reporting of CADI data and a need for guidelines when reporting and publishing quality-of-life data.

Influence of Selected Food Product Groups Consumption Frequency on Acne-Related Quality of Life in a National Sample of Polish Female Adolescents

“…The AQoL Scale and SOCQOL Score calculated based on it are indicated to be useful to evaluate the association between acne severity and the quality of life, especially in the case of mildly to moderately affected patients [ 26 ]. Similarly, the ADQ and CADI score calculated based on it are indicated to be characterized by a high internal consistency, test–retest reliability, responsiveness to change, and significant correlation with other tools [ 28 ].…”

“…In order to assess acne-related quality of life, two questionnaires were applied: the Acne Quality of Life (AQoL) Scale, which was developed and validated by Gupta et al [ 26 ], and the Acne Disability Questionnaire (ADQ), which was developed by Motley et al [ 27 ] and also validated [ 28 ].…”

“…The ADQ [ 27 , 28 ] is based on questions about the extent to which adolescents experience the described feelings as a result of their acne, and about their opinions on their acne, with 5 items being included. The feelings/opinions on their acne are described as: (1) feeling aggressive, frustrated, or embarrassed; (2) feeling interference in daily social life, social events, or relationships with members of the opposite sex; (3) avoided public changing facilities or wearing swimming costumes; (4) feelings about the appearance of skin; (5) how bad they think their acne is.…”

“…The respondent is asked to score each item from 0 to 3. Based on the ADQ, the Cardiff Acne Disability Index (CADI) may be calculated as the total value for 5 items, resulting in a total score from 0 to 15 [ 27 , 28 ].…”

Psychosocial Burden Due to Acne Vulgaris Affects Treatment-Seeking Behavior in Medical Students in Jakarta, Indonesia

“…The classification of the psychosocial burden was divided into unaffected (score 0), mild (score 1-5), moderate (6-10), and severe (11)(12)(13)(14)(15). 7,8 Then, the dermatologist assessed the AV degree according to the ASEAN Lehmann classification; mild designated as <20 comedones, <15 papules or pustules, without nodule; moderate for 20-100 comedones, 15-50 papules or pustules, <5 nodules; and severe for >100 comedones, >50 papules or pustules, >5 nodules.…”