Patient Measurement of Psoriasis Disease Severity with a Structured Instrument

Fleischer, Alan B.; Rapp, Stéphen R.; Reboussin, David M.; Vanarthos, Jill; Feldman, Steven R.

doi:10.1111/1523-1747.ep12384205

Cited by 89 publications

(76 citation statements)

References 6 publications

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“…In order to be applicable for the Internet setting, we used a modified version of the SAPASI with direct estimation of BSA involvement. The distribution in our sample of the mSAPASI was 9.5 ± 8.9, which is almost identical to the distribution of the SAPASI in its validation study [40]. Both WLQ and DLQI are instruments with adequate psychometric properties but have not been validated in an Internet setting before [26, 37].…”

Section: Discussionsupporting

confidence: 67%

“…The self-administered Psoriasis Area and Severity Index (SAPASI) is a patient-rated instrument with adequate psychometric properties to assess the objective clinical severity of psoria sis [38,39,40,41,42]. To be applicable in the Internet setting, the SAPASI was slightly modified (mSAPASI): as in the original version, patients rated the intensity of erythema, induration and scaliness on a 12-cm visual analogue scale (VAS) [40].…”

Section: Methodsmentioning

confidence: 99%

“…To be applicable in the Internet setting, the SAPASI was slightly modified (mSAPASI): as in the original version, patients rated the intensity of erythema, induration and scaliness on a 12-cm visual analogue scale (VAS) [40]. For estimation of the involved body surface area (BSA), patients were informed that the area of their palmar hand equals roughly 1% of their BSA.…”

Section: Methodsmentioning

confidence: 99%

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Work Limitations and Productivity Loss Are Associated with Health-Related Quality of Life but Not with Clinical Severity in Patients with Psoriasis

2006

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Background: According to current guidelines the cost of productivity loss should be considered in pharmacoeconomic analyses. The cost of health-related productivity loss in psoriasis patients is unknown. Objective: To estimate the cost of productivity loss in psoriasis and its association with health-related quality of life and clinical disease severity. Methods: Cross-sectional study, recruitment of adult participants through Internet advertisements. 201 (72.3%) out of 278 eligible participants completed the study. Health-related work productivity loss, quality of life and clinical severity of psoriasis were assessed by standardized instruments. Results: Indirect costs of productivity loss clearly exceed the total direct cost. In contrast to objective clinical disease severity, health-related quality of life (measured by the Dermatology Life Quality Index) is an independent predictor of work productivity. Conclusions: There is good reason to believe that intervention can reduce health-related productivity loss by improving patients’ quality of life. Savings from increased work productivity might offset comparatively high acquisition costs of biological agents.

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Section: Discussionsupporting

confidence: 67%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Work Limitations and Productivity Loss Are Associated with Health-Related Quality of Life but Not with Clinical Severity in Patients with Psoriasis

2006

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“…Also in previous studies 6,7,15,16 it was suggested that SAPASI was a good predictor of PASI. An excellent correlation between the 2 scores was found, although with substantial differences in the estimation for individual patients.…”

Section: Commentmentioning

confidence: 87%

Performance of the Self-administered Psoriasis Area and Severity Index in Evaluating Clinical and Sociodemographic Subgroups of Patients With Psoriasis

et al. 2003

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“…To maintain compatibility with the wealth of earlier studies using PASI whilst improving precision in the range of BSA <10%, the validated clinical procedure of PASI measurement is applied with the actual percentage of area involvement instead of the imprecise area classes intervals [6,[9][10][11] .…”

mentioning

confidence: 99%

Detection of small changes of psoriasis intensity with the PrecisePASI

2014

Journal of the American Academy of Dermatology

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Background: The Psoriasis Area and Severity Index (PASI) is the score of choice to grade psoriasis severity and detect clinical changes. Due to low resolution based on the calculation of the score by fixed area classes, PASI scores <10 have little value. Methods: At 756 patient examinations, psoriasis activity was measured with both PASI and PrecisePASI. Results: PrecisePASI has a linear increase while PASI has a staircase pattern. Both scores meet at the endpoint-relevant values of body surface area (BSA) 10, 30, 50, 70 and 90%. PASI and PrecisePASI correlate significantly over the whole range of BSA. In the region of BSA <5%, PrecisePASI shows a significantly higher resolution (p < 0.0001). Conclusion: The calculation of PrecisePASI corrects the undesired inaccuracies of PASI in the lower BSA ranges and is a tool to use as an endpoint in trials aiming to detect differences in the lower ranges of BSA. . This occurs because PASI uses a discontinuous score from 0 to 6 to grade area involvement rather than the actual percentages of area involvement ( fig. 1 ). If the area of involvement changes within an area score interval, i.e. from 1% increasing to 9% which are both graded as area involvement of '1', the PASI remains unchanged due to its calculation. In addition, the reproducibility of PASI has been criticized repeatedly [2-5] due to inter-observer variation, overestimation of the involved areas by untrained observers [6,7] as well as its non-linear scale and lack of sensitivity at the lower end of its range [4] .However, as PASI is the gold standard of measurement of psoriasis disease activity, we did not seek to create a new score, but rather to improve sensitivity in the lower range of body surface area (BSA) by using a novel method of calculating the PASI score. PrecisePASI is calculated with the exact percentage of area involvement and may thus reflect small changes in surface involvement more accurately [8] .For milder psoriasis, PASI is rarely used and no single score of choice has been earmarked. To maintain compatibility with the wealth of earlier studies using PASI whilst improving precision in the range of BSA <10%, the validated clinical procedure of PASI measurement is applied with the actual percentage of area involvement instead of the imprecise area classes intervals [6,[9][10][11] . Key Words Psoriasis severity · PASI · Psoriasis Area and Severity Index · PrecisePASIAbstract Background: The Psoriasis Area and Severity Index (PASI) is the score of choice to grade psoriasis severity and detect clinical changes. Due to low resolution based on the calculation of the score by fixed area classes, PASI scores <10 have little value. Methods: At 756 patient examinations, psoriasis activity was measured with both PASI and PrecisePASI. Results: PrecisePASI has a linear increase while PASI has a staircase pattern. Both scores meet at the endpoint-relevant values of body surface area (BSA) 10, 30, 50, 70 and 90%. PASI and PrecisePASI correlate significantly over the whole range of BSA. In the regi...

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Patient Measurement of Psoriasis Disease Severity with a Structured Instrument

Cited by 89 publications

References 6 publications

Work Limitations and Productivity Loss Are Associated with Health-Related Quality of Life but Not with Clinical Severity in Patients with Psoriasis

Work Limitations and Productivity Loss Are Associated with Health-Related Quality of Life but Not with Clinical Severity in Patients with Psoriasis

Performance of the Self-administered Psoriasis Area and Severity Index in Evaluating Clinical and Sociodemographic Subgroups of Patients With Psoriasis

Detection of small changes of psoriasis intensity with the PrecisePASI

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