The reliability and validity of outcome measures for atopic dermatitis in patients with pigmented skin: A grey area.
The reliability and validity of outcome measures for atopic dermatitis in patients with pigmented skin: A grey area.
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DOI：
10.1016/j.ijwd.2015.05.002
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发表时间：
2015-08
影响因子：
--
通讯作者：
Murrell DF
中科院分区：
文献类型：
--
作者：
Zhao CY;Wijayanti A;Doria MC;Harris AG;Jain SV;Legaspi KN;Dlova NC;Law MG;Murrell DF
针对色素性皮肤特应性皮炎 (AD) 患者的结果测量尚未开发或验证。比较四种常见 AD 结果测量在不同皮肤黑度患者中的可靠性和有效性。由 5 名训练有素的临床医生使用全身照片，对 18 名不同皮肤暗度程度的患者进行了 EASI（湿疹面积和严重程度指数）、客观评分特应性皮炎 (oSCORAD)、三项目严重性指数 (TIS) 和六面积、六部位特应性皮炎 (SASSAD) 的评估者间和评估者内信度和结构效度的评估。对于高度色素沉着的患者，评估者间可靠性组内系数 (ICC) 和 95% 置信区间较差：EASI -.054（-.200 至 .657）、oSCORAD -.089（-.206 至 .598）、TIS -.21（-.24 至 .147）、SASSAD -.071（-.200 至 .631）；对于轻度色素沉着患者公平：EASI .464(.140-.839)、oSCORAD .588(.265-.89)、TIS.524(.200-.865)、SASSAD .41(.045-.775)；对于非色素沉着患者，从一般到良好：EASI .64(.330-.908)、oSCORAD .586(.263-.889)、TIS .403(.09-.809)、SASSAD .667(.358-.916)。红斑可能导致评估者之间的差异。在非色素沉着患者的所有测量中，构建效度都具有显着相关性，但在高度色素沉着的患者中没有相关性。 AD 结果测量在高度色素沉着的患者中可靠性和有效性都很差，其中红斑感知的变化是一个因素。
Outcome measures for atopic dermatitis (AD) patients with pigmented skin have neither been developed nor validated. To compare the reliability and validity of four common AD outcome measures in patients with various levels of skin darkness. The inter- and intra-rater reliability and construct validity of the EASI (Eczema Area and Severity Index), objective-SCORing Atopic Dermatitis (oSCORAD), Three Items Severity index (TIS) and Six Areas, Six Sites Atopic Dermatitis (SASSAD) were evaluated in 18 patients of various levels of skin darkness, using their full body photographs, by five trained clinicians. The inter-rater reliability intraclass coefficient (ICCs) and 95% confidence intervals were poor for highly pigmented patients: EASI -.054(-.200 to .657), oSCORAD -.089(-.206 to .598), TIS -.21(-.24 to .147), SASSAD -.071(-.200 to .631); fair for mildly pigmented patients: EASI .464(.140-.839), oSCORAD .588(.265-.89), TIS.524(.200-.865), SASSAD .41(.045-.775); and fair to good for non-pigmented patients: EASI .64(.330-.908), oSCORAD .586(.263-.889), TIS .403(.09-.809), SASSAD .667(.358-.916). Erythema likely contributed to the inter-rater variability. Construct validity had significant correlations across all measures in non-pigmented patients, but no correlations in highly pigmented patients. AD outcome measures have poor reliability and validity in highly pigmented patients, with variations in erythema perception being a contributor.