Osnabrueck hand eczema severity index – a study of the interobserver reliability of a scoring system assessing skin diseases of the hands

Abstract

An easy-to-use standardized instrument is needed for the clinical assessment of the severity of occupational hand eczema by dermatologists as well as occupational physicians. The Osnabrueck hand eczema severity index (OHSI) was developed for this purpose and the interobserver reliability investigated. The clinical severity was evaluated on the basis of the extension or clinical characteristics of six morphological characteristics. For the validation of the OHSI, hand eczema in 28 patients was investigated independently by one dermatologist and 2 occupational physicians. The agreement between the observers was determined by using kappa values, Kendall's coefficient of concordance, the intraclass correlation coefficient (ICC) and the 95% limits of agreement. The ICC for the total OHSI was 0.80 and the estimated limits of agreement (-3.6 and 3.0) were sufficiently small to expect that ratings according to OHSI performed by independent observers of different medical specialities should produce similar results. It could be demonstrated that the use of the OHSI is simple and practicable. The interobserver reliability for the summary score is good. OHSI seems a reliable tool for assessing the severity of occupational hand eczema.

Prevalence of skin and back diseases in geriatric care nurses

“…The OHSI is a summed score, with values between 0 and 18. Interobserver reliability for the OHSI scoring system was studied by Skudlik et al (2006) and gave good agreement between diVerent observers. For the sample of occupational physicians in our study, the prevalence of positive OHSI results varied between 8 and 27% (interquartile range).…”

“…For this reason, the score we selected for our study was the OHSI for assessment of the severity of skin changes in hand eczema. This instrument can be used rapidly and simply by non-dermatologists (Skudlik et al 2006). We deliberately did not employ strict criteria for the classiWcation of positive orthopedic or dermatological diagnosis, as we considered that it was important to record minor impairment of function of the back and minor symptoms of skin changes, which are reversible with early prevention.…”

Skin health and safety at work in Croatian hairdressing apprentices

“…The skin of the hands was examined by occupational physicians using the validated Osnabrueck Hand Eczema Severity Index (OHSI) to determine the presence of six different morphological characteristics -erythema, scaling, papules, vesicles, infiltration, and fissures -and the extent of the affected skin area (24,25). Transepidermal water loss (TEWL) was measured on the forearm and on the dorsum of the hand (Tewameter ® TM 300, Courage + Khazaka Electronic, Cologne, Germany) with the standard procedure suggested by the manufacturer.…”

The Prevalence of Hand Dermatitis in Nurses: A Narrative Review Highlighting the Importance of Prevention

“…Most of the studies measured HD using a questionnaire. Some, such as the "Contact disease severity index" [26] have been validated and standardised [27,28]. One of them, the "Nordic Occupational Skin Questionnaire" [28], has been translated into other languages, including Spanish [29].…”