Reliability, Validity and Feasibility of the Vitiligo Extent Score (VES) and Self-Assessment Vitiligo Extent Score (SA-VES) Among Vitiligo Patients: A Cross-Cultural Validation

Chaweekulrat, Pichanee; Silpa‐archa, Narumol; Apinuntham, Chalermkwan; Chaiyabutr, Chayada; Wongpraparut, Chanisada

doi:10.2147/ccid.s324073

Cited by 5 publications

(4 citation statements)

References 13 publications

(46 reference statements)

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“…The authors of the introductory article mention that the main advantage of the VES is its intuitiveness due to the use of images, user‐friendliness and clarity. The tool can be used to calculate the extent of vitiligo in local areas (e.g., facial VES) as well as total body BSA 9,10 . The VES has the potential to be translated into clinically meaningful severity categories (grade 0–6), which may improve communication between physicians and could be useful for inclusion criteria in clinical trials and grading results.…”

Section: Resultsmentioning

confidence: 99%

“…The tool can be used to calculate the extent of vitiligo in local areas (e.g., facial VES) as well as total body BSA. 9,10 The VES has the potential to be translated into clinically meaningful severity categories (grade 0-6), which may improve communication between physicians and could be useful for inclusion criteria in clinical trials and grading results. Several possible limitations are included in the introductory article.…”

Section: Facial Vitiligo Area Scoring Index (F-vasi)mentioning

confidence: 99%

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Clinician‐reported outcome measures for the assessment of vitiligo: A scoping review

van Geel,

Duponselle,

Delbaere

et al. 2023

Acad Dermatol Venereol

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Clinician‐reported outcome measures (ClinROMs) are essential for assessment of vitiligo in clinical trials and daily practice. Several instruments have been developed and tested to measure e.g., vitiligo extent, repigmentation and activity. The goal of this review was to identify all introductory publications of ClinROMs for vitiligo that include at least some aspects of validation and to describe the instruments’ characteristics, intention for use, and practical strengths and limitations. A search strategy was conducted in Pubmed, Embase and Cochrane Library (CENTRAL) from inception to July 2022. Based on the literature search (n=2860), 10 articles were identified, describing 14 different ClinROMs. 6 ClinRoms measured disease extent and/or repigmentation, 7 evaluated disease activity and 1 was a composite score. The Vitiligo Area Scoring Index (VASI), and Vitiligo Extent Score [VES and VESplus] measure overall disease extent and/or repigmentation. The VASI relies on hand units (1% body surface are) whereas the VES and VESplus uses a picture‐based scoring technique. The Vitiligo Extent Score for a Target Area (VESTA) measures repigmentation percentage for target lesions. One global assessment score for extent has been validated. Vitiligo disease activity scores included a static measure of clinical activity signs [Vitiligo Signs of Activity Score (VSAS)] and two measures assessing dynamic evolution [(Vitiligo Disease Activity Score (VDAS), Vitiligo Disease Improvement Score (VDIS)]. The Vitiligo European Task Force assessment tool (VETFa) is a composite score. Depending on the practical strength and limitations as well as the research question and setting (clinical trials versus daily practice) the choice of an appropriate ClinROM may differ. Fourteen ClinROMs in vitiligo were identified to measure vitiligo extent, repigmentation and activity. Further research evaluating the validity, reliability and responsiveness of each instrument and worldwide consensus on which instrument to use for a specific outcome (domain) is greatly needed.

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Section: Resultsmentioning

confidence: 99%

Section: Facial Vitiligo Area Scoring Index (F-vasi)mentioning

confidence: 99%

Clinician‐reported outcome measures for the assessment of vitiligo: A scoping review

van Geel,

Duponselle,

Delbaere

et al. 2023

Acad Dermatol Venereol

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“…A widespread automated assessment for disease extent is still missing, introducing some interrater variability. The intraclass correlation coefficients (ICCs) of the VASI and VES are 0.85–0.99 and 0.95–0.99, respectively, resulting in a 1%–15% and 1%–5% variation (Chaweekulrat et al, 2021; Merhi et al, 2022). The ICCs are lower in patients with extensive vitiligo (ICC: VASI: 0.76 vs. VES: 0.92) (van Geel et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

A meta‐analysis of the placebo response in vitiligo: Causes and consequences for the interpretation of clinical trials

Speeckaert,

van Geel

2023

Pigment Cell Melanoma Res

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The current understanding of the placebo response in vitiligo is limited. Nonetheless, it is difficult to compare the outcomes of vitiligo trials if the repigmentation rates in placebo patients vary significantly. We conducted a meta‐analysis of the placebo response in vitiligo trials. Overall, repigmentation rates in patients receiving placebo were 22%, ranging substantially from 0 to 60%. Repigmentation (>25%) was still relatively common for placebo (9.35%), but fell to 5% when >50% improvement was analyzed. Higher frequencies of placebo responses correlated with more repigmentation in the intervention groups. Facial vitiligo and sunlight exposure was linked to higher placebo responses. Roughly estimating the amount of improvement using quartiles (0–25, 25%–50%, 50%–75%, 75%–100% repigmentation) resulted in higher placebo rates compared to other assessment methods. In clinical studies with older patients, the ratio of placebo reactions to treatment responses was higher. This is likely because clinical trials with older patients reported less repigmentation after treatment than studies with younger patients. The percentual difference in affected body surface area during the study period ranged from 6.2% worsening to 17.6% improvement in the placebo groups. This high variability in placebo responses illustrates the need for standardized outcome measures and more head‐to‐head trials in vitiligo.

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“…The current gold standard for diagnosing vitiligo relies on clinical examination, yet certain presentations, particularly early or evolving lesions, may be missed, necessitating additional diagnostic tools for confirmation. Various numerical scales also exist to assess outcome measurements for vitiligo, including the including the well-validated Vitiligo Extent Score (VES), the Self-Assessment Vitiligo Extent Score (SA-VES), and Vitiligo Area Scoring Index (VASI) (4)(5)(6). Commonly used diagnostic techniques for vitiligo include dermoscopy, Wood's lamp, digital photography with computerized image analysis, and invasive methods such as skin biopsies, however, several emerging, non-invasive techniques are currently being investigated.…”

Section: Introductionmentioning

confidence: 99%

Non-invasive skin measurement methods and diagnostics for vitiligo: a systematic review

Abdi¹,

Anthony²,

Farkouh³

et al. 2023

Front. Med.

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Vitiligo is a multifaceted autoimmune depigmenting disorder affecting around 0.5 to 2.0% of individuals globally. Standardizing diagnosis and therapy tracking can be arduous, as numerous clinical evaluation methods are subject to interobserver variability and may not be validated. Therefore, there is a need for diagnostic tools that are objective, dependable, and preferably non-invasive.AimsThis systematic review provides a comprehensive overview of the non-invasive objective skin measurement methods that are currently used to evaluate the diagnosis, severity, and progression of vitiligo, as well as the advantages and limitations of each technique.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used for the systematic review. Scopus, Embase, Cochrane Library, and Web of Science databases were comprehensively searched for non-invasive imaging and biophysical skin measuring methods to diagnose, evaluate the severity of, or monitor the effects of vitiligo treatment. The risk of bias in included articles was assessed using the QUADAS-2 quality assessment scale.ResultsAn extensive literature search resulted in 64 studies for analysis, describing eight imaging techniques (reflectance confocal microscopy, computer-aided imaging analysis, optical coherence tomography, infrared photography, third-harmonic generation microscopy, multiphoton microscopy, ultraviolet light photography, and visible light/digital photograph), and three biophysical approaches (dermoscopy, colorimetry, spectrometry) used in diagnosing and assessing vitiligo. Pertinent information about functionality, mechanisms of action, sensitivity, and specificity was obtained for all studies, and insights into the strengths and limitations of each diagnostic technique were addressed. Methodological study quality was adequate; however, statistical analysis was not achievable because of the variety of methods evaluated and the non-standardized reporting of diagnostic accuracy results.ConclusionsThe results of this systematic review can enhance clinical practice and research by providing a comprehensive overview of the spectrum of non-invasive imaging and biophysical techniques in vitiligo assessment. Studies with larger sample sizes and sound methodology are required to develop verified methods for use in future practice and research.Systematic review registration(PROSPERO) database, (CRD42023395996).

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Reliability, Validity and Feasibility of the Vitiligo Extent Score (VES) and Self-Assessment Vitiligo Extent Score (SA-VES) Among Vitiligo Patients: A Cross-Cultural Validation

Cited by 5 publications

References 13 publications

Clinician‐reported outcome measures for the assessment of vitiligo: A scoping review

Clinician‐reported outcome measures for the assessment of vitiligo: A scoping review

A meta‐analysis of the placebo response in vitiligo: Causes and consequences for the interpretation of clinical trials

Non-invasive skin measurement methods and diagnostics for vitiligo: a systematic review

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