A pilot comparison study of four clinician‐rated atopic dermatitis severity scales

Zhao, Cathy; Tran, An; Lazo-Dizon, Johanna Pauline H.; Kim, J.; Daniel, Benjamin; Venugopal, Supriya S.; Rhodes, Lesley; Law, Matthew; Murrell, Dédée F.

doi:10.1111/bjd.13846

Cited by 37 publications

(36 citation statements)

References 30 publications

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“…Similar results for the EASI were observed previously by Hanifin et al [12] on a group of 20 patients with AD and 15 dermatologists; the overall intra-evaluator reliability of the EASI was in the fair-togood range. In the other study performed by Zhao et al [19] on 12 patients and 5 dermatologists, the EASI demonstrated excellent intra-rater reliability. In our study all signs of AD evaluated with EASI showed similar reproducibility (good to fair intra-rater reliability), except for lichenification (poor intra-rater reliability).…”

Section: Discussionmentioning

confidence: 69%

“…In contrast to that study, Zhao at al. [19] have demonstrated poor inter-rater reliability of oSCORAD. In the same study, the EASI had good inter-rater reliability [18] .…”

Section: Discussionmentioning

confidence: 98%

“…To our knowledge, only 1 study has investigated the reproducibility of the oSCORAD, showing relatively poor intra-rater reliability [19] . In our study the IGA has demonstrated only fair intra-rater reliability, the lowest of the 3 compared scales.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of Intra- and Inter-Rater Reliability of Three Methods for Measuring Atopic Dermatitis Severity: EASI, Objective SCORAD, and IGA

Bożek

Reich²

2017

Dermatology

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Background: Numerous different scoring systems have been proposed for assessing the severity of atopic dermatitis (AD). Many of these methods did not undergo proper validation and reliability testing. Objective: The aim of our study was to compare the reliability and reproducibility of the Eczema Area and Severity Index (EASI), objective Scoring Atopic Dermatitis (oSCORAD), and Investigator Global Assessment (IGA). Methods: On the scoring day, 10 trained dermatologists evaluated 10 adult patients with AD using the EASI, oSCORAD, and IGA. All subjects were assessed twice by each physician. Correlations between measures were analysed using the Pearson correlation coefficient. The intra-class correlation coefficient (ICC) was calculated to assess intra-rater reliability; the coefficient of variation (CV) was used to assess inter-rater variability. Results: Significant positive correlations were observed between each scale in both assessments. The ICCs for the EASI and oSCORAD were 0.71 and 0.66, respectively, indicating good reliability, while the ICC for the IGA (0.54) indicated only fair reliability. The CVs for the oSCORAD and IGA were 28.1 and 33.0, respectively, indicating moderate variability. The CV for the EASI was 66.5, indicating high variability. Conclusion: Among the 3 compared scales, the oSCORAD had the highest inter-rater reliability, whereas the EASI had the highest intra-rater reliability. None of the 3 scoring methods showed a significant advantage over the other. Thus, a reliable assessment of AD severity requires the use of at least 2 independent measurements simultaneously.

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Section: Discussionmentioning

confidence: 69%

“…In contrast to that study, Zhao at al. [19] have demonstrated poor inter-rater reliability of oSCORAD. In the same study, the EASI had good inter-rater reliability [18] .…”

Section: Discussionmentioning

confidence: 98%

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Assessment of Intra- and Inter-Rater Reliability of Three Methods for Measuring Atopic Dermatitis Severity: EASI, Objective SCORAD, and IGA

Bożek

Reich²

2017

Dermatology

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“…Many authors have presented data on the correlation of QoL and AD severity as a secondary outcome, but in addition there are several studies primarily aiming to study this correlation. Correlations have been reported between the generic measure Short‐Form Health Survey (SF‐36), dermatology‐specific measures DLQI, CDLQI, Skindex‐29, AD‐specific measures IDQoL, the family QoL measure DFI, the German questionnaire ‘Quality of life in parents of children with atopic dermatitis’ and PIQoL‐AD, along with scoring of AD (SCORAD), patient‐oriented (PO)‐SCORAD, Eczema Area and Severity Index (EASI) and other AD severity scales . There have been significant positive correlations between DLQI, IDQOL, DFI with SCORAD, and some studies not finding such correlation .…”

Section: Resultsmentioning

confidence: 99%

Quality of life measurement in atopic dermatitis. Position paper of the European Academy of Dermatology and Venereology (EADV) Task Force on quality of life

Chernyshov

Tómas-Aragonés

Manolache³

et al. 2017

Acad Dermatol Venereol

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There is a need for researchers to have easy reference to the wide spectrum of different types of quality of life (QoL) instruments that can be used in atopic dermatitis (AD). Previous reviews on QoL in AD do not cover the full spectrum of QoL measures used in studies on AD. This study, on behalf of the European Academy of Dermatology and Venereology (EADV) Task Force on QoL, contains information on instruments available for health-related QoL and family QoL assessment in AD including information on validation, experience of QoL assessment in AD for different purposes, peculiarities of QoL assessment in different age groups, expert analysis of available instruments including data on limitations of their use and recommendations of the Task Force.

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“…ABSIS = Autoimmune Bullous Skin Disorder Intensity Score; BPDAI = Bullous Pemphigoid Disease Area Index; CDASI = Cutaneous Dermatomyositis Disease Area and Severity Index; CLASI = Cutaneous Lupus Erythematosus Disease Area and Severity Index; EBDASI = Epidermolysis Bullosa Disease Activity and Scarring Index; EASI = Eczema Acvitity and Scarring Index; MCID = minimal clinically-important difference; PASI = Psoriasis Area and Severity Index; PDAI = Pemphigus Disease Area Index; SCORAD = Scoring Atopic Dermatitis. 1 Rahbar et al, 2014; 2 Murrell et al, 2008; 3 Boulard et al, 2016; 4 Shimizu et al, 2014, 5 Pfutze et al, 2007; 6 Gourraud et al, 2012; 7 Puzenat et al, 2010; 8 Tofte et al, 1998; 9 Hanifin et al, 2001; 10 Breuer et al, 2004; 11 Schram et al, 2012; 12 Sartorius et al, 2010; 13 Loh et al, 2014; 14 Jain et al, 2016; 15 Wijayanti et al, 2014, Wijayanti et al, 2016; 16 Murrell et al, 2012; 17 Patsatsi et al, 2012; 18 Lévy-Sitbon et al, 2014; 19 Bonilla-Martinez et al, 2008; 20 Albrecht et al, 2005; 21 Klein et al, 2011; 22 Goreshi et al, 2012; 23 Anyanwu et al, 2015; 24 Stalder et al, 1993; 25 Schram et al, 2012; 26 Angelova-Fischer et al, 2005; 27 Langley and Ellis, 2004; 28 Zhao et al, 2015.…”

Section: Figmentioning

confidence: 99%

Validation studies of outcome measures in pemphigus

Hanna

Kim

Murrell

2016

International Journal of Women's Dermatology

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Pemphigus is a group of rare and potentially fatal autoimmune blistering diseases that are associated with auto-antibodies that target intercellular adhesion molecules. Incidence of pemphigus varies among populations, with the lowest incidence in Switzerland and Finland at 0.6–0.76 per million per year and the highest in Jewish communities at 16.1–32 per million per year. Pemphigus is associated with devastating morbidity and despite advancements in our understanding of the disease and a widening array of therapeutic options, no cure exists. The delay in the development of a cure may in part be attributed to the absence of a standardized and completely validated severity outcome measures to allow for high-quality multicenter control studies. Such a tool is necessary to define the best practice in clinical studies, allow for accurate comparisons between study results, justify drug use within the clinical setting, and reduce the cost burden that is associated with the use of ineffective therapies. Utilizing outcome measures that are not validated provides an opportunity to synthesize outcome measures with the intent to favor particular treatments and thus produce false conclusions. According to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) group, a validation of these measurement instruments requires investigating their responsiveness, reliability, and validity. More than 116 outcome measures exist to assess pemphigus severity, of which the Pemphigus Disease Area Index (PDAI), Autoimmune Bullous Skin Disorder Intensity Score (ABSIS), and Pemphigus Vulgaris Activity Score (PVAS) are the most comprehensively corroborated measures. With regard to validity and reliability, PDAI was unsurpassed by ABSIS and PVAS. Data indicate that ABSIS is more reliable than PVAS, but PVAS seems to have greater validity although the results are not consistent. PDAI, ABSIS, and PVAS have not yet had their responsiveness analyzed, which should be the next step to completely validate the outcome measures and conclusively determine which measure is superior.

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A pilot comparison study of four clinician‐rated atopic dermatitis severity scales

Abstract: EASI demonstrated the highest inter-rater and intrarater reliability, supporting it as the optimal AD severity outcome measure.

Cited by 37 publications

References 30 publications

Assessment of Intra- and Inter-Rater Reliability of Three Methods for Measuring Atopic Dermatitis Severity: EASI, Objective SCORAD, and IGA

Assessment of Intra- and Inter-Rater Reliability of Three Methods for Measuring Atopic Dermatitis Severity: EASI, Objective SCORAD, and IGA

Quality of life measurement in atopic dermatitis. Position paper of the European Academy of Dermatology and Venereology (EADV) Task Force on quality of life

Validation studies of outcome measures in pemphigus

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