Validation of the 5-D Itch Scale in Three Ethnic Groups and Exploring Optimal Cutoff Values Using the Itch Numerical Rating Scale

Abstract

Background. Chronic pruritus is a common and distressing condition that has serious emotional and psychosocial consequences. Due to its subjective nature, self-report questionnaires are widely implemented as cost-effective measures to gauge the severity of chronic pruritus. The current study is aimed at validating the 5-D itch scale in three ethnic groups—Black, Asian, and Hispanic—with the well-validated Itch Numerical Rating Scale (NRS) and Worst Itch NRS (WI-NRS) and developing its cutoff value using receiver operating characteristics (ROC) and inspection of the area under the curve (AUC) across ethnic groups. At the same time, it is aimed at comparing the concurrent prevalence of itch and depression in these populations, who often form ethnic minorities in many countries. The current study addresses the knowledge gap of cultural adaptation of the 5-D pruritus scale for greater usage. Methods. Community samples of three ethnic groups were recruited from an online platform of Qualtrics and administered the self-report questionnaires of Itch-NRS, 5-D itch scale, and Patient Health Questionnaire-9 (PHQ-9) to measure their pruritus domains, itch intensity, depression screening, and its severity. Informed consent was obtained from all participants. Subgroup analysis was conducted, including concurrent validity and cutoff values compared between each ethnic group. Concurrent prevalence of itch and depression was evaluated using the cutoff value of Itch-NRS and PHQ-9. Result. A total of 2323 participants were included in the study. A significant positive correlation ( p < 0.001 ) was found between the Itch-NRS, WI-NRS, and 5-D itch scale. The cutoff value of the 5-D itch scale was established for the three ethnic groups using ROC, with a cutoff value of Itch-NRS as a reference. Conclusions. The 5-D itch scale has demonstrated sound psychometric properties in three ethnic groups and is closely related to Itch-NRS. The analysis of the cutoff value of the 5-D itch scale suggests that different cutoff values should be considered to reduce the inflation of pruritus severity.

Hand Eczema in High School Students in Poland: A Cross-sectional Study

“…Moreover, those students who reported the presence of hand lesions during the previous week completed the following Polish language validated questionnaires: Dermatology Life Quality Index (DLQI) ( 11 ), 6-Item Stigmatization Scale (6-ISS) ( 12 ), Hospital Anxiety of Depression Scale (HADS) ( 13 ). Intensity of worst itch and pain during the last 3 days was measured with a numerical rating scale (NRS) ( 3 , 14 , 15 ). The severity of quality of life impairment (DLQI) was considered as follows: 0–1 point, no effect; 2–5 points, small effect; 6–10 points, moderate effect; 11–20 points, very large effect; and 21–30 points, extremely large effect on patients’ life ( 16 ).…”

“…The severity of quality of life impairment (DLQI) was considered as follows: 0–1 point, no effect; 2–5 points, small effect; 6–10 points, moderate effect; 11–20 points, very large effect; and 21–30 points, extremely large effect on patients’ life ( 16 ). The following cut-off points were used for itch severity: less than 3 points, mild itch; 3–7 points, moderate itch; 7–9 points, severe itch; and more than 9 points, very severe itch ( 3 , 14 , 15 ). Intensity of pain was assessed based on the following cut-off score: ≤ 5 points, mild pain; > 5–7 points, moderate pain; > 7–10 points, severe pain ( 3 , 14 , 15 ).…”

“…The following cut-off points were used for itch severity: less than 3 points, mild itch; 3–7 points, moderate itch; 7–9 points, severe itch; and more than 9 points, very severe itch ( 3 , 14 , 15 ). Intensity of pain was assessed based on the following cut-off score: ≤ 5 points, mild pain; > 5–7 points, moderate pain; > 7–10 points, severe pain ( 3 , 14 , 15 ). Statistical analysis was performed with the IBM SPSS Statistics v. 26 (SPSS Inc., Chicago, IL, USA) software.…”

Chronic Kidney Disease–Associated Pruritus and Quality of Life: Learning from Our Patients

“…Two of the most used multi-dimensional scales are the 5-D Itch Scale and the Itch Severity Scale (ISS) [ 39 , 40 , 41 ]. The 5-D Itch Scale [ 39 ] was designed as a brief instrument to assess the presence of pruritus over time.…”

Corrigendum to “Validation of the 5-D Itch Scale in Three Ethnic Groups and Exploring Optimal Cutoff Values Using the Itch Numerical Rating Scale”

“…In the article titled “Validation of the 5-D Itch Scale in Three Ethnic Groups and Exploring Optimal Cutoff Values Using the Itch Numerical Rating Scale” [ 1 ], the authors requested the following correction to the acknowledgement statement:…”