Outcome measures of disease severity in atopic eczema
Outcome measures of disease severity in atopic eczema
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DOI：
10.1001/archderm.136.6.763
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发表时间：
2000-06-01
影响因子：
--
通讯作者：
Williams, H
中科院分区：
文献类型：
--
作者：
Charman, C;Williams, H
背景：循证医学的一个重要组成部分是在临床试验中使用有效和可靠的结局指标。在特应性湿疹领域，关于如何最好地客观地测量疾病严重程度存在许多困惑。目的：建立现有的特应性湿疹客观临床量表的有效性、可靠性、变化敏感性和可接受性。设计：对所有目前可用的特应性湿疹量表进行电子文献检索。结果：总共确定了13个尺度。10个量表的结构效度或标准效度数据可用。仅对5个量表进行了可靠性检验（观察者间变异性、观察者内变异性或内部一致性）。有8个量表的变化响应性数据可用。已为3个比额表提供了实施这一措施的估计时间。唯一的严重程度量表，其已发表的数据可以找到有效性，可靠性，敏感性，和可接受性测试是特应性皮炎指数的严重程度评分，虽然问题发生了观察者之间的变化的指数。特应性湿疹严重程度量表的数量迅速增加，其中许多未得到充分测试，使得对患者的解释变得混乱，研究结果之间的比较几乎是不可能的。临床医生和研究人员对特应性湿疹严重程度量表的使用应基于足够的有效性、可靠性、对变化的敏感性和易用性的证据。
Background: An essential component of evidence-based medicine is the use of valid and reliable outcome measures in clinical trials. There is much confusion in the field of atopic eczema regarding how to best measure disease severity objectively.Objective: To establish the extent to which existing objective clinical scales for atopic eczema have been tested for validity, reliability, sensitivity to change, and acceptability.Design: An electronic bibliographic search was performed for published data on all currently available named atopic eczema scales.Results: Thirteen scales were identified in total. Data on construct or criterion validity were available for 10 scales. Only 5 scales had been tested for reliability (interobserver variability, intraobserver variability, or internal consistency). Data on responsiveness to change were available for 8 scales. An estimated time to administer the measure had been given for 3 scales. The only severity scale for which published data could be found on validity, reliability, sensitivity, and acceptability testing was the Severity Scoring of Atopic Dermatitis index, although problems occurred with interobserver variation of the index.Conclusion: The rapidly increasing number of severity scales for atopic eczema, many of which have been inadequately tested, has made the interpretation of patient out comes confusing, and comparison of results between studies almost impossible. Consensus among clinicians and researchers on the use of severity scales for atopic eczema should be based on evidence of adequate validity, reliability, sensitivity to change, and ease of use.