Interobserver Variation in the Assessment of Rosacea

Bamford, Joel T.M.

doi:10.1001/archderm.134.4.508

Cited by 12 publications

(10 citation statements)

References 5 publications

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“…The kappa statistic as an instrument of measuring reproducibility has not been used frequently in dermatology. One example for its use is in an investigation of the interobserver variation of two rosacea scores 16 . It is not mentioned which kappa was used and whether it was weighted or not.…”

Section: Discussionmentioning

confidence: 99%

Reproducibility of a four-point clinical severity score for glabellar frown lines

et al. 2003

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Section: Discussionmentioning

confidence: 99%

Reproducibility of a four-point clinical severity score for glabellar frown lines

et al. 2003

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“…16,17 These scales are subjective and often not validated, decreasing confidence in the validity of reported outcomes. 7,[16][17][18][19] Moreover, visual evaluation alone cannot appreciate processes unfolding below the skin surface. Histopathological findings are nonspecific, 1 but experienced dermatopathologists are generally able to diagnose rosacea based on characteristic histological and immunohistochemical features, 20 which can overlap among subtypes.…”

Section: What Does This Study Add?mentioning

confidence: 99%

Noninvasive objective skin measurement methods for rosacea assessment: a systematic review

et al. 2019

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Summary Background Rosacea assessment and therapy monitoring can be challenging to standardize, as most clinical evaluation systems are prone to interobserver variability and not always validated. Therefore, objective, reliable and preferably noninvasive measurement tools are needed. Objectives To give insight into available noninvasive imaging techniques and biophysical methods in rosacea by performing a systematic review. Methods PubMed, Embase, Cochrane and Web of Science databases were searched until 1 September 2018 in accordance with PRISMA guidelines, to identify studies providing original data about objective noninvasive imaging and/or biophysical skin measurement techniques for diagnosis, assessing severity or therapy monitoring of adult patients with cutaneous facial rosacea. Risk of bias of included articles was assessed with the Cochrane Risk of Bias tool, Quality in Prognosis Studies tool, and the Newcastle–Ottawa Scale. Results A total of 78 studies were included, describing 14 imaging and biophysical methods. Widespread information about (sub)surface cutaneous morphology and functionality was obtained. Methodological study quality was relatively low and interstudy outcome variability was large. Several tools show promising value in research settings: for treatment follow‐up Demodex mites are countable with reflectance confocal microscopy, spectrometry can quantify erythema, and rosacea severity could be objectified with skin hydration‐ and transepidermal water loss measurements. Conclusions This systematic review describes the spectrum of noninvasive imaging and biophysical methods in rosacea assessment, giving multifaceted information about structure and properties of rosacea skin, especially useful for research purposes. Larger studies with good methodological quality are needed to create validated protocols for further implementation into research. What's already known about this topic? Rosacea is a chronic inflammatory skin disease with a variety of clinical manifestations. Most clinical evaluation systems are subjective, not always validated, and subsurface skin processes remain unnoticed. Currently, different types of noninvasive measurement tools are available for rosacea assessment and therapy monitoring, but a comprehensive overview is lacking. What does this study add? Seventy‐eight publications were included, describing 14 imaging and biophysical tools, providing a wide range of information about rosacea skin morphology and functionality. Reflectance confocal microscopy and spectrometry are especially promising in therapy monitoring and skin barrier measurements for rosacea severity assessment. Larger studies with better methodological quality are needed to create validated protocols for implementation into research.

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“…The only instances in which researchers used or evaluated methods that had been developed by other investigators were (a) the work Bamford (a coauthor of this review) in using the system for grading rosacea severity developed by Henderson at Walsgrave Hospital in the United Kingdom 3 in creating the Duluth Rosacea Severity Index (DRSI), 4,7 and (b) Herr 9 in subsequent use of the DRSI. In neither instance were the earlier methods published in detail; in both instances replication of the methods was based on other communication.…”

Section: Discussionmentioning

confidence: 99%

“…The study documented the limited sensitivity of both instruments, and relatively low levels of interobserver reliability. It was concluded that “neither scale would be appropriate for a multiobserver or mulitcenter study” and that further work would be needed in the development of a rosacea severity scale 4 …”

Section: Introductionmentioning

confidence: 99%

“…It was concluded that "neither scale would be appropriate for a multiobserver or mulitcenter study" and that further work would be needed in the development of a rosacea severity scale. 4 At present, the monitoring of the severity of rosacea rests on clinical judgement. There are no laboratory tests or standardized tools to assist the clinician or researcher in assessing or monitoring the severity of the condition.…”

Section: Introductionmentioning

confidence: 99%

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