Outcome Measures of Disease Severity in Atopic Eczema

Abstract

Background: An essential component of evidencebased medicine is the use of valid and reliable outcome measures in clinical trials. There is much confusion in the field of atopic eczema regarding how to best measure disease severity objectively.Objective: To establish the extent to which existing objective clinical scales for atopic eczema have been tested for validity, reliability, sensitivity to change, and acceptability.Design: An electronic bibliographic search was performed for published data on all currently available named atopic eczema scales.Results: Thirteen scales were identified in total. Data on construct or criterion validity were available for 10 scales. Only 5 scales had been tested for reliability (interobserver variability, intraobserver variability, or internal consistency). Data on responsiveness to change were available for 8 scales. An estimated time to administer the measure had been given for 3 scales. The only severity scale for which published data could be found on validity, reliability, sensitivity, and acceptability testing was the Severity Scoring of Atopic Dermatitis index, although problems occurred with interobserver variation of the index. Conclusion:The rapidly increasing number of severity scales for atopic eczema, many of which have been inadequately tested, has made the interpretation of patient outcomes confusing, and comparison of results between studies almost impossible. Consensus among clinicians and researchers on the use of severity scales for atopic eczema should be based on evidence of adequate validity, reliability, sensitivity to change, and ease of use.

Assessment of the severity of atopic dermatitis

“…Wynik SASSAD dobrze koreluje z ogólną oceną choroby przez pacjenta i lekarza, objawami subiektywnymi (nasilenie świądu i zaburzenia snu) oraz odpowiedzią na miejscowe glikokortykosteroidy, natomiast słabo z parametrami oceny jakości życia [27]. W badaniu w małej grupie 6 pacjentów stwierdzono dużą zmienność pomiędzy poszczególnymi badaczami, zwłaszcza w ocenie lichenizacji i suchości skóry [28].…”

A programme of research to set priorities and reduce uncertainties for the prevention and treatment of skin disease

“…Following systematic research, 175,299,306,312,313 an international online Delphi consensus study on core outcome domains 307 and an exploratory meeting (HOME I) that resulted in the formation of the HOME group, 176 the study presented here was the first extended 2-day meeting in which patient representatives, clinicians, methodologists and pharmaceutical industry representatives with an interest in AE outcomes research from various parts of the world met, worked together and formed an active working group. A significant strength of HOME is the close links with the OMERACT group, a similar initiative in rheumatology that started in 1992.…”

Avaliação da eficácia e segurança do tacrolimo pomada 0,03% no tratamento da dermatite atópica em pacientes pediátricos

“…10 Todos os parâmetros foram avaliados nas semanas 1, 3 e 6 do tratamento e na semana 8 (duas semanas após o tratamento).…”