What are the best outcome measurements for atopic eczema? A systematic review
What are the best outcome measurements for atopic eczema? A systematic review
复制标题
DOI：
10.1016/j.jaci.2007.08.011
复制
发表时间：
2007-12-01
影响因子：
14.2
通讯作者：
Williams, Hywel C.
中科院分区：
文献类型：
--
作者：
Schmitt, Jochen;Langan, Sinead;Williams, Hywel C.
背景：有效和可靠的结果测量是循证实践的先决条件。评估特应性湿疹（AE）严重程度的结果测量的相对有效性和可靠性尚不清楚。目的：我们试图评估AE结果测量的效度、信度、对变化的敏感性和易用性。我们还试图就临床研究和临床监测中使用的结果提出建议。方法：对临床专家和患者进行系统回顾和调查。结果：确定了20个已发表的结果测量值。有证据表明，3个测量指标（特应性皮炎指数严重程度评分[SCORAD]、湿疹面积和严重程度指数[EASI]和三项严重程度评分）的结构效度足够，1个量表（面向患者的湿疹测量[POEM]）的内部一致性足够，5个测量指标（基本临床评分系统、Nottingham湿疹严重程度评分、特应性皮炎客观严重程度评估）的观察者间信度足够。六区、六征特应性皮炎严重程度评分；和SCORAD)， I量表（POEM）具有足够的重测信度，对3项测量（EASI、SCORAD和调查者全球特应性皮炎评估）的变化具有足够的敏感性。大多数结果测量有足够的内容效度，由患者和专家评估。对8项结果测量确定了进行评估的时间数据。只有SCORAD、EASI和POEM经过了充分的测试和充分的执行。结论：已发表的AE预后指标过多。大多数药物没有得到适当的检测，在检测时也没有充分发挥作用，它们的继续使用阻碍了科学传播。临床意义：目前只有SCORAD、EASI和POEM表现良好。这些量表应该在未来的研究中使用。
Background: Valid and reliable outcome measurements are a prerequisite for evidence-based practice. The comparative validity and reliability of outcome measurements for assessing atopic eczema (AE) severity is unclear.Objective: We sought to assess the validity, reliability, 44 sensitivity to change, and ease of use of outcome measurements for AE. We also sought to give recommendations on which outcomes to use in clinical research and for clinical monitoring.Methods: We performed a systematic review and survey of clinical experts and patients.Results: Twenty published outcome measurements were identified. There is evidence of adequate construct validity for 3 measurements (Severity Scoring of Atopic Dermatitis index [SCORAD], Eczema Area and Severity Index [EASI], and Three Item Severity Score), adequate internal consistency of 1 scale (Patient-oriented Eczema Measure [POEM]), adequate interobserver reliability of 5 measurements (Basic Clinical Scoring System; Nottingham Eczema Severity Score; Objective Severity Assessment of Atopic Dermatitis; Six Area, Six Sign Atopic Dermatitis severity score; and SCORAD), adequate test-retest reliability of I scale (POEM), and adequate sensitivity to change of 3 measurements (EASI, SCORAD, and Investigators' Global Atopic Dermatitis Assessment). Most outcome measurements have adequate content validity, as assessed by patients and experts. Data on the time to perform the assessment was identified for 8 outcome measurements. Only SCORAD, EASI, and POEM have been tested sufficiently and performed adequately.Conclusion: There are too many published outcome measures for AE. Most have not been tested properly or perform adequately when tested, and their continued use hampers scientific communication.Clinical implications: Only SCORAD, EASI, and POEM currently perform adequately. These scales should be used in future studies.