Rishi Chopra, M.S.
Jonathan Silverberg, M.D.
Dermatology
severity, atopic dermatitis, banding, patient-reported outcomes, clinical outcomes, eczema
Ryan Family Atrium, Robert H. Lurie Medical Research Center
Multiple patient-reported outcomes have been used to assess the burden of atopic dermatitis (AD). Some are disease specific, e.g. the Patient Oriented Eczema Measure (POEM). While others pertain to itch, e.g. Numerical Rating Scale, ItchyQoL and 5-D itch, or dermatologic disease in general, e.g. Dermatology Life Quality Index. Development of severity bands is essential for proper interpretability of these assessments. We sought to confirm previously developed bands for POEM, NRS-itch, DLQI and ItchyQoL and develop bands for the 5-D itch scale for use in adults with AD. Self-administered questionnaires were completed by 210 adults with AD in a dermatology practice setting. Bands were selected using an anchoring approach based on self-reported disease severity. We confirmed the existing bands for POEM (mild=0.7, moderate=8-16, severe=17-28) (kappa=0.44), DLQI (mild=0-5, moderate=6-10, severe=11-30) (kappa=0.40) and NRS-itch (mild=0-3, moderate=4-6, severe=7-10) (kappa=0.5). Banding in our adult AD population for ItchyQoL was mild=0-36, moderate=37-54, severe=55-110) (kappa=0.40). The preferred band for 5-D itch scale was mild=0-11, moderate=12-17 and severe=18-25 (kappa=0.33). In conclusion, existing bands for POEM, DLQI and NRS-itch perform well in adult AD. We recommend using a different band for ItchyQoL as well as the proposed bands for 5-D itch scale in adult AD.