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

Abstract

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.