Assessment of the severity of atopic dermatitis

Bożek, Agnieszka; Reich, Adam

doi:10.5114/dr.2016.63839

Cited by 5 publications

(9 citation statements)

References 35 publications

(59 reference statements)

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“…Many available measures exist for the assessment of AD severity [15] . The increasing heterogeneity of reported outcomes hinders their comparability and translation to clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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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“…Many available measures exist for the assessment of AD severity [15] . The increasing heterogeneity of reported outcomes hinders their comparability and translation to clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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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“…In patients from the study group (with newly diagnosed FA, not being on an elimination diet), we analysed the most common clinical manifestations of FA, the severity of clinical symptoms (considering the number of organs/systems involved), and the severity of atopic dermatitis (AD) based on the SCORAD index [ 28 ].…”

Section: Methodsmentioning

confidence: 99%

Assessment of Selected Intestinal Permeability Markers in Children with Food Allergy Depending on the Type and Severity of Clinical Symptoms

Niewiem

Grzybowska-Chłebowczyk

2022

Nutrients

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Background: Food allergy (FA) has a broad range of symptoms, and clinical manifestations may concern several reactions from one system or organ. Aim: The aim of the study was to assess intestinal permeability (IP) based on the analysis of serum zonulin and bacterial lipopolysaccharides (LPS) levels in children with FA, taking into account the pathomechanism of immune reaction, clinical symptoms of FA and their severity. Material and methods: The study comprised 103 patients aged 7–60 months (median 34); 49 children with IgE-mediated allergy and 25 children with non-IgE-mediated allergy; the reference group comprised 29 children with functional gastrointestinal disorders. IP markers were determined using ELISA. Results: There was no correlation between the severity of clinical symptoms and the level of IP markers in children with FA. Zonulin and LPS levels were significantly higher in children with FA and gastrointestinal symptoms. Zonulin levels in the subgroup of children with non-IgE-mediated FA and gastrointestinal symptoms were significantly higher than in the subgroup of children with IgE-mediated FA and these symptoms. The level of LPS was significantly higher in the subgroup with IgE-mediated FA and atopic dermatitis. Conclusions: Zonulin and LPS levels were significantly higher in children with FA compared to children from the reference group. Zonulin levels were significantly higher in children with non-IgE-mediated FA than in children with IgE-mediated FA.

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“…The Rajka–Langeland severity score was shown to have overall good concurrent, convergent and discriminant validity, moderate‐to‐good reliability, fair responsiveness, and no floor/ceiling effects. Surprisingly, in the study by Silverberg et al ., test–retest comparison of EASI and SCORAD demonstrated significantly worse reproducibility than had previously been reported by other authors, which needs to be further investigated 1,6,7 . This is of great relevance, as EASI has both shown excellent reliability for and been recommended as the optimal score measure for patients of all skin colours 7 …”

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confidence: 92%

“…This assessment tool, developed in 1989 by Rajka and Langeland as one of the first AD severity scales, consists of three domains: body surface area (BSA) affected by AD, intensity of itch and disease course 5 . To date, the severity of AD has usually been assessed with the Eczema Area and Severity Index (EASI), the Scoring of Atopic Dermatitis (SCORAD) and/or the Physician Global Assessment 1 . Remarkably, in their study Silverberg et al .…”

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confidence: 99%

“…Facing the need to obtain more robust and reliable results from studies on various therapeutic modalities and the growing costs of clinical trials, a valid assessment of disease severities has now become particularly relevant. Regarding atopic dermatitis (AD), many available measures exist for its assessment; however, none is currently considered as a gold standard 1 . The major difficulty in assessing AD severity relies on the need to evaluate both objective clinical severity as well as the subjective symptoms reported by patients.…”

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confidence: 99%

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