Relation between patients' and physicians' severity assessment of occupational hand eczema

Cvetkovski, RS; Jensen, Henning Tarp; Olsen, Jørn; Johansen, Jeanne Duus; Agner, Tove

doi:10.1111/j.1365-2133.2005.06768.x

Cited by 37 publications

(33 citation statements)

References 10 publications

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“…No significant difference was reported between females and males with respect to severity. In a previous study comparing doctor-assessed to patient-assessed severity, a tentative agreement between objective and self-rated evaluation was found (13), since the patient-assessed severity takes into consideration the patient's distress and discomfort from the disease, which the objective assessment does not. More females seem to be emotionally distressed from dermatitis than males (7,8), and this could eventually lead to a higher degree of severity reported in the female group.…”

Section: Discussionmentioning

confidence: 92%

Gender Differences in Topical Treatment of Allergic Contact Dermatitis

Noiesen¹,

Munk²,

Larsen³

et al. 2009

Acta Derm Venerol

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Section: Discussionmentioning

confidence: 92%

Gender Differences in Topical Treatment of Allergic Contact Dermatitis

Noiesen¹,

Munk²,

Larsen³

et al. 2009

Acta Derm Venerol

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“…On the other hand, patients may emphasize symptoms of FD or HD because of the psychosocial burden related to dermatitis in these areas. In a recent study, where the self‐rated severity of dermatitis was evaluated, an increased number of severe cases were reported by patients compared with the dermatologists’ assessment (14). In our study, only the occurrence of dermatitis was asked and not the severity.…”

Section: Discussionmentioning

confidence: 95%

Contact sensitivity and atopic dermatitis: association with prognosis, a follow‐up study in 801 atopic patients

2007

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The influence of contact sensitivities on the course of atopic dermatitis (AD) is not known. The objective of the study is to find the course of AD in atopic patients with and without contact sensitivities. A total of 801 atopic patients were studied and patch tested in 1983/84. A questionnaire focusing on the occurrence of dermatitis was sent to these patients 16 years later. During the follow up the number of symptom-free patients increased from 36.7% to 40.7%. In patients with positive patch-test reactions, 30.1% were symptom free in 1983/84 and 38.3% at the follow up (P= 0.001). Among those with positive patch-test reactions to fragrance mix and/or balsam of Peru, the number of symptom-free patients had increased the most: from 26.9% to 42.6% (P= 0.0095), and a similar tendency was seen among those with nickel allergy. The occurrence of dermatitis did not change among patients without contact sensitivities. Thus, the study concluded that contact allergy does not impair the prognosis of dermatitis in atopic patients.

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“…Cvetkovski et al 13 described how the patients’ self‐assessment of their hand eczema was significantly more severe than the dermatologist's rating, who used a standardized severity assessment tool. This resulted in a very low positive predictive value and a high negative predictive value of the patient's self‐assessment.…”

Section: Discussionmentioning

confidence: 99%

Assessment of severity of hand eczema: discrepancies between patient- and physician-rated scores

Coevorden

Sonderen

Bouma

et al. 2006

British Journal of Dermatology

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Summary Background In clinical practice or trials on hand eczema the severity of this disease can be ‘measured’ in different ways: by means of a physician‐rated clinical severity score, a patient‐rated clinical severity score or by an indicator of the burden of disease. We assume that the patient‐rated severity score corresponds more with the (change in) burden of disease than with the physician‐rated severity score. Objectives To demonstrate how physicians and patients differ in their assessment of the severity of hand eczema as seen in a physician‐rated severity score, patient‐rated severity score and a burden of disease questionnaire. Methods We used data from an open‐label randomized controlled trial which was set up in two university hospital dermatology departments in the Netherlands, specializing in hand eczema. One hundred and fifty‐eight patients with moderate to severe chronic hand eczema were included. The main outcome measures were the physician‐rated severity score, based on five visible aspects of hand eczema (desquamation, erythema, vesicles, infiltration, fissures), the patient‐rated severity score (a self‐rating scale), a burden of disease questionnaire (the Dermatology Life Quality Index, DLQI) and the correlations between these parameters, both at inclusion and over time. Results Only desquamation and infiltration were significantly correlated with patient‐rated severity score. Patient‐rated severity score correlated with seven of 10 DLQI items, but it did not correlate with the items regarding influence on clothes worn, impairment of sporting activities, and problems associated with treatment of the skin. The majority of patients showed improvement in all parameters after treatment. However, the improvement in patient‐rated severity score was not clearly correlated with changes in physician‐rated severity score. Except for DLQI item 1 (itch, soreness, pain, stinging), none of the changes in burden of disease was correlated with changes in patient‐rated severity score. For each DLQI item, change over time correlated weakly with decreases in several, but not all, components of the physician‐rated severity score. Conclusions Disease severity can be expressed by different scores; these scores are not clearly correlated, and measure different aspects. Patient satisfaction is not guaranteed when treatment is focused solely on the visible aspects of hand eczema. Instead, burden of disease has a greater impact.

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Relation between patients' and physicians' severity assessment of occupational hand eczema

Cited by 37 publications

References 10 publications

Gender Differences in Topical Treatment of Allergic Contact Dermatitis

Gender Differences in Topical Treatment of Allergic Contact Dermatitis

Contact sensitivity and atopic dermatitis: association with prognosis, a follow‐up study in 801 atopic patients

Assessment of severity of hand eczema: discrepancies between patient- and physician-rated scores

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