Content validity of the Recap of atopic eczema (RECAP) instrument in Dutch, English and German to measure eczema control in young people with atopic eczema: a cognitive interview study

Gabes, Michaela; Ragamin, Aviël; Baker, Arabella; Kann, Gesina; Donhauser, Theresa; Gabes, Daniela; Howells, Laura; Kim, Thomas; Oosterhaven, Jart A F; Pasmans, Suzanne G.M.A.; Schuttellaar, Marie-L; Apfelbacher, Christian

doi:10.1111/bjd.21767

Cited by 6 publications

(3 citation statements)

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“…The content validity of RECAP has also been assessed in various studies ( 19 – 21 , 28 , 29 ). The self-reported version of RECAP has been reported to be appropriate for use from the age of 12 years ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…The HOME VII meeting in 2019 recommended the use of the Atopic Dermatitis Control Test (ADCT) or RECAP as measures for long-term control as part of the core set of outcomes to be reported in all eczema trials (16,17). RECAP was developed and validated in English, but currently other language versions of RECAP such as German, Dutch, and Spanish versions were also considered comprehensible, and adults, as well as parents of affected children (19)(20)(21).…”

Section: Numerous Outcome Measures Have Been Developedmentioning

confidence: 99%

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Validation of the Recap of Atopic Eczema (RECAP) Measurement Instrument for Eczema Control in Adult Patients in an Asian Clinical Setting

Yew,

Phuan,

Zhao

et al. 2024

Acta Derm Venereol

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Recap of atopic eczema (RECAP) is a self-reported 7-item questionnaire recommended by the Harmonising Outcome Measures in Eczema initiative to measure eczema control. As RECAP has not been validated in a real-world clinical population in Asia, RECAP was investigated as a measure of eczema control in Singapore. Patients with atopic eczema at the National Skin Centre from July 2019 to January 2020 were included for analysis. Both patient- and physician-reported outcome measures were available for correlation analyses. Correlation analysis was also performed to investigate construct validity, and floor or ceiling effects of RECAP. A total of 260 atopic eczema patients aged between 15 and 87 years were recruited. There were minimal floor and ceiling effects for RECAP scores. There were strong, significant correlations of RECAP with POEM (r = 0.84, p < 0.001) and DLQI (r = 0.81, p < 0.001). Correlation with SCORAD was moderate (r = 0.60, p < 0.001). Correlations remained similar after age, gender, and ethnicity adjustments. Discriminative validity was demonstrated by a significant linear trend of increasing RECAP scores with increasing eczema severity. RECAP demonstrates good discriminative and construct validity evidenced by strong correlations with symptoms and quality of life and moderate correlations with eczema signs. RECAP is useful to measure eczema control in Singapore.

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Section: Discussionmentioning

confidence: 99%

Section: Numerous Outcome Measures Have Been Developedmentioning

confidence: 99%

Validation of the Recap of Atopic Eczema (RECAP) Measurement Instrument for Eczema Control in Adult Patients in an Asian Clinical Setting

Yew,

Phuan,

Zhao

et al. 2024

Acta Derm Venereol

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“…The 2 long-term eczema control instruments in the latter study showed strong correlation. Additionally, Gabes et al found the self-reported English, German, and Dutch RECAP relevant and comprehensible in young people from 12 years of age ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Cross-Cultural Validation of the RECAP of Atopic Eczema Questionnaire in a Swedish Population

Sigurdardottir,

Alsterholm,

Andersson

et al. 2024

Acta Derm Venereol

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A Swedish translation of the patient-reported outcome measure for assessing long-term control of atopic dermatitis, Recap of atopic eczema (RECAP), has not been validated. Cross-cultural translation and multi-centre validation of the translated RECAP questionnaire were therefore performed. Disease severity was assessed using the validated Investigator Global Assessment Scale for atopic dermatitis (vIGA-ADTM). The Swedish RECAP was completed by 208 individuals aged 16 years or older with a median age of 36 years (interquartile range [IQR] 27–48). The participants considered the questionnaire suitable for assessing eczema control. The median RECAP score (range 0–28) was 12 (IQR 5–19). The mean and median vIGA-ADTM scores (range 0–4) were 2 (standard deviation [SD] 2) and 3 (IQR 2–4), respectively. A correlation between RECAP and the vIGA-ADTM was observed (p < 0.001). There was no significant change in scores for participants who answered the questionnaire twice within 14 days. Over time, improved or worsened eczema, as evaluat-ed by vIGA-ADTM, affected RECAP scores significantly (p < 0.001). The study suggests that RECAP can assess AD control in a Swedish clinical setting and shows -acceptable reliability.

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Validity, reliability, responsiveness and interpretability of the Recap of atopic eczema (RECAP) questionnaire

Zhang

Ragamin

Romeijn

et al. 2023

British Journal of Dermatology

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Background Limited research has been conducted on the measurement properties of the Recap of atopic eczema (RECAP) questionnaire, particularly its interpretability. Objectives To investigate the validity, reliability, responsiveness, and interpretability of the Dutch RECAP in adults with atopic dermatitis (AD). Methods We conducted a prospective study in a Dutch tertiary hospital, recruiting adults with AD between June 2021 and December 2022. Patients completed the RECAP questionnaire, reference instruments, and anchor questions at three time points: baseline, after 1-3 days, and after 4-12 weeks. Validity: Hypotheses-testing was used to investigate single-score validity and change-score validity (responsiveness). Reliability: Both standard error of measurement (SEMagreement) and intraclass correlation coefficient (ICCagreement) were reported. Interpretability of single score: Bands for eczema control were proposed. Interpretability of change score: Both smallest detectable change (SDC) and minimally important change (MIC) scores were determined. To estimate the MIC scores, four different anchor-based methods were employed: the mean change method, 95% limit cut-off point, receiver operating characteristic curve, and predictive modelling. Results In total, 200 participants were included (57.5% male, mean age 38.5 years). Of the a priori hypotheses, 82% (single-score validity) and 59% (responsiveness) were confirmed. Known-group analyses showed differences in the RECAP scores between patient groups based on disease severity and impairment of the quality of life. The SEMagreement was 1.17 points, and the ICCagreement was 0.988. The final banding was: 0-1 (completely controlled); 2-5 (mostly controlled); 6-11 (moderately controlled); 12-19 (a little controlled); 20-28 (not at all controlled). Moreover, a single cut-off point of ≥6 was determined to identify patients whose AD is not under control. The SDC was 3.2 points, and the MIC value from the predictive modeling was 3.9 points. Neither floor nor ceiling effects were seen. Conclusion The RECAP has good single-score validity, moderate responsiveness and excellent reliability. This study fills a gap in the interpretability of the RECAP. Our results indicate a threshold of ≥6 points to identify patients whose AD is ‘not under control’, while an improvement of ≥4 points represents a clinically important change. Given its endorsement by the Harmonising Outcome Measures for Eczema (HOME) initiatives, the results of this study support the integration of RECAP into both routine clinical practice and research settings.

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Content validity of the Recap of atopic eczema (RECAP) instrument in Dutch, English and German to measure eczema control in young people with atopic eczema: a cognitive interview study

Abstract: and Laura Howells were involved in the original development of Recap of atopic eczema (RECAP). All three are members of the executive committee of the Harmonising Outcome Measures for Eczema (HOME) initiative. Laura Howells has acted as a consultant for the University of Oxford on an

Cited by 6 publications

References 28 publications

Validation of the Recap of Atopic Eczema (RECAP) Measurement Instrument for Eczema Control in Adult Patients in an Asian Clinical Setting

Validation of the Recap of Atopic Eczema (RECAP) Measurement Instrument for Eczema Control in Adult Patients in an Asian Clinical Setting

Cross-Cultural Validation of the RECAP of Atopic Eczema Questionnaire in a Swedish Population

Validity, reliability, responsiveness and interpretability of the Recap of atopic eczema (RECAP) questionnaire

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Content validity of the Recap of atopic eczema (RECAP) instrument in Dutch, English and German to measure eczema control in young people with atopic eczema: a cognitive interview study

Abstract: and Laura Howells were involved in the original development of Recap of atopic eczema (RECAP). All three are members of the executive committee of the Harmonising Outcome Measures for Eczema (HOME) initiative. Laura Howells has acted as a consultant for the University of Oxford on an

Cited by 6 publications

References 28 publications

Validation of the Recap of Atopic Eczema (RECAP) Measurement Instrument for Eczema Control in Adult Patients in an Asian Clinical Setting

Validation of the Recap of Atopic Eczema (RECAP) Measurement Instrument for Eczema Control in Adult Patients in an Asian Clinical Setting

Cross-Cultural Validation of the RECAP of Atopic Eczema Question­naire in a Swedish Population

Validity, reliability, responsiveness and interpretability of the Recap of atopic eczema (RECAP) questionnaire

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Cross-Cultural Validation of the RECAP of Atopic Eczema Questionnaire in a Swedish Population