Background: We have previously reported how the SCORAD index was designed. This cumulative index combines objective (extent and intensity of lesions) and subjective (daytime pruritus and sleep loss) criteria. Aims: To study interobserver variability in scoring for objective SCORAD criteria and to optimize the scoring guidelines. Material and Methods: Three scoring sessions were organized in 1993-1994 in Hamburg, Bordeaux and Rotterdam totalizing 19 patients (14 children and 5 adults) and 23 physicians, among whom 12 participated in at least 2 scoring sessions; 169 evaluation sheets have been processed using the SCORAD File Marker Pro software. At each session, total body photographs and close-up views were taken of each patient, and this material was reviewed at the final evaluation. Results: The extent of lesions according to the rule of nines showed interobserver variability mostly for patients with lesions of moderate intensity involving 20–60% of body surface. Intensity items were scored with more consistency overall, but variations subsided especially for oozing/crusts and lichenifications. Low and high scorer profiles and the benefit of training were noted. Conclusions: This study has allowed to optimize clinical scoring using the SCORAD system. A proposal has been made to grade the severity of atopic dermatitis according to objective criteria in three groups for inclusion in clinical trials. The SCORAD index remains the major criterion for follow-up in trials.

Cancer patients taking opioids for pain are very frequently constipated, even if they are prescribed laxatives. This leads to relevant impairments of quality-of-life.

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The PromptPR patient record originates from the research and development project DILEMMA (1992-94) and has been undertaken in the context of the research project PROMPT (4th Framework Health Telematics). Here we present the work undertaken with the doctors of the project RISA (Réseau d'Information de Santé en Aquitaine) in order to adapt the patient record to their various practical medical conditions. Effectively, there are implications for general practitioners, the private sector and hospital personnel. The richness of the workgroup and the adoption of a participative methodology, guided by the demands of the end-users allowed the creation of an electronic patient record (EPR) sufficiently simple and generic as to serve as a common base for both general practitioners and hospital medical staff. Independent of this system, the multimedia interface presented is based on frames, which enables visualization of the EPR either vertically or horizontally, with access to both the multimedia and external documentation of the patient. This web interface is the result of a consensus of opinion within the group.