Validation of the Skindex-16 questionnaire in patients with skin diseases in Morocco

Fakir, Samira El; Baybay, H; Bendahhou, Karima; Obtel, Majdouline; Benchat, L.; Mernissi, F.Z.; Nejjari, Chakib

doi:10.3109/09546634.2012.681016

Cited by 13 publications

(7 citation statements)

References 18 publications

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“…Our results relative to test-retest reliability were satisfactory, as the ICC values were above 0.7 for all three Skindex-16 domains. Our findings are in accordance with previous studies [ 10 , 30 ] indicating that Skindex-16 exhibits satisfactory reproducibility.…”

Section: Discussionsupporting

confidence: 93%

“…The Cronbach’s alpha values found were similar to those obtained in the original validation study, which developed the questionnaire by reducing the number of items in Skindex-29 [ 10 ]. Regarding the subsequent validation studies in other languages [ 25 – 30 ], Cronbach’s alpha values were always higher than 0.7, which can be considered acceptable.…”

Section: Discussionmentioning

confidence: 96%

“…Therefore, we suggest that item 5 be modified or even that a new 15-item version of the instrument be considered and tested in future studies in Brazil. [ 25 – 30 ]. None of the mentioned studies reported barriers for understanding item 5 of Skindex-16.…”

Section: Discussionmentioning

confidence: 99%

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The Brazilian version of Skindex-16 is a valid and reliable instrument to assess the health-related quality of life of patients with skin diseases

et al. 2018

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IntroductionThe aim of this study was to assess the psychometric properties of the Brazilian version of Skindex-16 in patients with various skin diseases.MethodsDermatologic assessments were performed for the diagnosis and classification of the severity of skin conditions. The clinical feasibility of Skindex-16 was assessed based on the time required to complete the questionnaire and the number of unanswered items. The participants (n = 110) answered the Hospital Anxiety and Depression Scale (HADS), the Dermatology Life Quality Index (DLQI) and the Skindex-16 (Portuguese/Brazil version) questionnaires. Convergent validity was assessed based on the correlation of the Skindex-16 with the DLQI and HADS subscales. Known-groups validity was assessed based on the comparison of the mild, moderate and severe disease groups using the Kruskal-Wallis test. Internal consistency was assessed using Cronbach’s alpha and test-retest reproducibility using the intraclass correlation coefficient (ICC) obtained with 29 participants who answered the Skindex-16 a second time 3 to 10 days after the first assessment.ResultsThe mean time to answer the questionnaire was 2 min 41 sec. Cronbach’s alpha scores were 0.867, 0.930 and 0.888 for the Skindex-16 domains symptoms, emotions and functioning, respectively. The ICCs were 0.947, 0.860 and 0.843 for the Skindex-16 domains symptoms, emotions and functioning, respectively. All three Skindex-16 scales exhibited strong correlations with DLQI. Moderate correlations were found between HADS subscales and the Skindex-16 emotions domain. Known-groups validity showed differences in all three Skindex-16 domains between the mild and moderate skin disease groups (emotions: p < 0.001; symptoms: p = 0.049; functioning: p < 0.001) and between the mild and severe skin disease groups (emotions: p = 0.002; symptoms: p = 0.001; functioning: p = 0.002).ConclusionThe Portuguese/Brazil version of Skindex-16 is a valid and reliable instrument to assess the quality of life of patients with skin diseases.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 96%

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The Brazilian version of Skindex-16 is a valid and reliable instrument to assess the health-related quality of life of patients with skin diseases

et al. 2018

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“…Because the psychometric properties of the two instruments differ in some aspects, using both instruments enables comparison of study findings with previous work in dermatology (Finlay and Khan, 1994). Both the DLQI and Skindex-16 have been validated in psoriasis patients with low through high disease severities (AlGhamdi and AlShammari, 2007;El Fakir et al, 2014;Essa et al, 2018;Finlay and Khan, 1994;Mazzotti et al, 2003Mazzotti et al, , 2005Safikhani et al, 2013). The outcomes were the differences in the mean improvement in the DLQI and Skindex-16 averaged over 3, 6, 9, and 12 months between the two arms.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…Skindex-16 and the Dermatology Life Quality Index (DLQI) are two well-accepted instruments that evaluate dermatology-specific quality of life and are responsive to change over time. These two instruments have shown excellent content validity and reliability in the psoriasis population (AlGhamdi and AlShammari, 2007;El Fakir et al, 2014;Essa et al, 2018;Safikhani et al, 2013), and their use can comprehensively capture psoriasis patients' perspectives regarding their quality of life.…”

Section: Introductionmentioning

confidence: 99%

Online Care Versus In-Person Care for Improving Quality of Life in Psoriasis: A Randomized Controlled Equivalency Trial

Armstrong

Ford

Chambers

et al. 2019

Journal of Investigative Dermatology

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This 12-month, pragmatic, randomized controlled equivalency trial evaluated whether an online, collaborative connected-health model results in equivalent improvements in quality of life compared with in-person care for psoriasis. Overall, 296 adults with physician-diagnosed psoriasis from ambulatory clinics were randomly assigned to either online or in-person care; all were analyzed for outcomes. In the online group, patients and primary care providers sought dermatologists' care directly and asynchronously online. The in-person group sought care face to face. Interventions did not allow blinding of participants; investigators were blinded during analysis. Across 12 months, for the online group, the mean AE standard deviation decline in Skindex-16 from baseline across follow-up visits was 9.02 AE 20.67 compared with 10.55 AE 23.50 for the in-person group. The difference in Skindex-16 between the two groups was e0.83 (95% confidence interval ¼ e5.18 to 3.51), and this was within the equivalence margin (AE7.0). For the online group, the mean AE standard deviation decline in Dermatology Life Quality Index was 1.64 AE 4.34 compared with 1.18 AE 4.77 for the in-person group. The difference in Dermatology Life Quality Index between the two groups was e0.45 (95% confidence interval ¼ e1.29 to 0.38) and was within the equivalence margin (AE2.5). In conclusion, the online model was as effective as inperson care in improving quality of life among psoriasis patients. This study was funded by the Patient-Centered Outcomes Research Institute and is registered on clinicaltrials.gov (NCT02358135).

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Skin-Related Quality of Life During Autoimmune Bullous Disease Course

Hopkins,

Jimenez,

Taliercio

et al. 2023

JAMA Dermatol

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ImportanceAutoimmune bullous diseases (AIBDs) are chronic relapsing-remitting conditions with significant morbidity. Skin-related quality of life (SRQL) may vary by AIBD subtype and disease type. Disease severity and flare severity can be difficult to define; SRQL can offer a key insight.ObjectivesTo investigate the Skindex-16 score as an SRQL measure in AIBD subtypes during flare and nonflare states and to evaluate Skindex-16 construct validity.Design, Setting, and ParticipantsThis retrospective cross-sectional study was conducted from September 1, 2016, to February 1, 2020, among 192 patients at the University of Utah Health autoimmune dermatology clinic with pemphigoid, pemphigus, dermatitis herpetiformis, and linear immunoglobulin A disease. Patients had an encounter-associated diagnosis, Skindex-16 scores, and self-reported flare status. Statistical analysis was performed from March 2022 to June 2023.ExposureAutoimmune bullous disease subtype and patient-reported flare status.Main Outcomes and MeasuresSkindex-16 domain scores (emotions, symptoms, and functioning; range, 0-100, where 0 indicates no effect on SRQL and 100 maximum effect) and individual item scores were described by disease and flare status. Flare scores were expected to be higher by at least the standard error of measurement (SEm). Convergent validity was assessed using Spearman correlation among Skindex-16 scores, serologic titers, and other patient-reported outcome measures. Floor or ceiling domain scores (&lt;20% of sample scoring either lowest or highest possible domain scores, respectively) were assessed for Skindex-16. Structural validity was assessed using confirmatory factor analysis (CFA).ResultsThe study included 192 patients with 212 visits (median age, 68 years [IQR, 58-76 years]; 123 of 212 women [58.0%]) with Skindex-16 scores (64 in flare state and 148 in nonflare state). Median Skindex-16 domain scores were higher for all disease categories among patients in the flare state compared with those in the nonflare state (pemphigoid [emotions: flare, 52.4 (IQR, 38.1-69.0); nonflare, 7 (IQR, 0-17); symptoms: flare, 37.5 (IQR, 29.2-58.0); nonflare, 13 (IQR, 0-25); functioning: flare, 26.7 (IQR, 10.0-56.7); nonflare, 0 (IQR, 0-3)]; pemphigus [emotions: flare, 54.8 (IQR, 31.0-81.0; nonflare, 0 (IQR, 0-19); symptoms: flare, 58.3 (IQR, 41.7-70.8); nonflare, 4 (IQR, 0-12.5); functioning: flare, 26.7 (IQR, 13.3-83.3); nonflare, 0 (IQR, 0-3.33)]; dermatitis herpetiformis [emotions: flare, 72.6 (IQR, 34.7-90.5); nonflare, 14.3 (IQR, 2.4-26.2); symptoms: flare, 69 (IQR, 31.3-85.4); nonflare, 12.5 (IQR, 0-29.2); functioning: flare, 38.3 (IQR, 5.0-63.2); nonflare, 0 (IQR, 0-13.3)]. This difference exceeded SEm cut points. Cronbach α was greater than 0.80 for all domains and AIBDs. Moderate or low correlations were seen with desmoglein 1 and bullous pemphigoid 180 titers. Moderate correlation existed between Skindex-16 and Patient-Reported Outcomes Measurement Information System Depression scores (emotions: ρ = 0.40; symptoms: ρ = 0.41; functioning: ρ = 0.48), and strong correlation existed between Skindex-16 and patient-reported disease severity (emotions: ρ = 0.71; symptoms: ρ = 0.73; functioning: ρ = 0.66). Floor domain scores greater than 20% were seen among patients in the nonflare state, but ceiling domain scores were rare (&lt;10% for all domains); CFA model fit was poor.Conclusions and RelevanceIn this cross-sectional study, SRQL was highly associated with flare of AIBDs. Skin-related quality of life was worse during periods without flare among patients with pemphigoid and dermatitis herpetiformis compared with pemphigus, highlighting residual SRQL morbidity. Skindex-16 showed good construct validity, but the poor CFA model fit needs further research. Clinical measurement of SRQL in AIBDs can add critical disease-severity information.

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Validation of the Skindex-16 questionnaire in patients with skin diseases in Morocco

Abstract: In general, the ﬁndings of this study indicated that the authors have developed a semantically equivalent translation of Skindex-16 into Moroccan Arabic. It is a reliable and valid measure of the effects of skin disease on the quality of life in Moroccan patients.

Cited by 13 publications

References 18 publications

The Brazilian version of Skindex-16 is a valid and reliable instrument to assess the health-related quality of life of patients with skin diseases

The Brazilian version of Skindex-16 is a valid and reliable instrument to assess the health-related quality of life of patients with skin diseases

Online Care Versus In-Person Care for Improving Quality of Life in Psoriasis: A Randomized Controlled Equivalency Trial

Skin-Related Quality of Life During Autoimmune Bullous Disease Course

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