Development and validation of a questionnaire to measure empowerment in adult patients with atopic dermatitis. The DATEMP questionnaire

Differences in Psychometric Properties of Clinician- and Patient-Reported Outcome Measures for Atopic Dermatitis by Race and Skin Tone: A Systematic Review

The psychometric validity and reliability of widely used atopic dermatitis (AD) outcome measures across different races and ethnicities are unclear. We describe the rates of reporting race, ethnicity, and skin tone in studies testing the psychometric properties of AD outcome measures and compare the psychometric analyses across race, ethnicity, and skin tone. We systematically reviewed MEDLINE and EMBASE for studies reporting psychometric properties of clinician-reported or patient-reported outcome measures in AD (International Prospective Register of Systematic Reviews: CRD42021239614). Overall, 16,100 nonduplicate articles were screened; 165 met inclusion criteria. Race and/or ethnicity were reported in 55 (33.3%) studies; of those, race was assessed by self-report in 10 studies (6.1%) or was unspecified in 45 (27.3%). A total of 16 studies (9.7%) evaluated psychometric property differences by race, and only five (4.4%) of those did not recognize it as a limitation. Properties assessed across race, ethnicity, or skin tone were differential item functioning, convergent validity feasibility, inter-rater reliability, intrarater reliability, test‒retest reliability, and known-groups validity. Multiple instruments demonstrated performance differences across ethnoracial groups. This review highlights the paucity of race/ethnicity consideration for psychometric property testing in AD outcome measurement instruments. More AD outcomes instruments should be validated in diverse populations.

Perception of the coronavirus pandemic by patients with atopic dermatitis - Results from the TREATgermany registry

BACKGROUND

TREATgermany, a registry for patients with moderate to severe atopic dermatitis (AD), established an additional questionnaire in spring 2020 to investigate the effects of the coronavirus pandemic on the daily life of patients with AD.

MATERIAL AND METHODS

A questionnaire was used to analyze general information regarding a patient's experience of the coronavirus pandemic and, using the Inventory of Life-Changing Events, the resulting personal burden. To analyze possible associations between disease severity (EASI score, oSCORAD, IGA, PGA, POEM), quality of life (DLQI) and personal burden, t-tests, analyses of variance and correlations were evaluated, controlled for sex and age.

RESULTS

58 % (n = 233) of the included 400 registry patients reported high burden scores caused by the coronavirus pandemic, regardless of an actual infection. Men showed significantly higher burden scores than women, and younger than older respondents (both P = 0.03). There were no differences in burden scores related to the physician's assessment of disease severity. However, patients with higher quality of life impairments and higher disease severity perceived the burden of the coronavirus pandemic as less severe (DLQI P = 0.019, PGA P = 0.044).

CONCLUSIONS

Our data show that registry patients considered the coronavirus pandemic as a life-changing event and perceived the burden differently. This should be taken into account in the treatment of patients with moderate to severe AD as well as in further studies.

Proposal of a self-assessment questionnaire for the diagnosis of sensitive skin

Background

Sensitive skin is very common and distressing. Its diagnosis may be difficult with the tools/methods available at the moment.

Aims

To assess the reliability of a self‐assessment questionnaire for the diagnosis of sensitive skin, using the results of lactic acid stinging test (LAST) as a reference for the identification of subjects suffering from this condition. A further objective was to identify the questionnaire cutoff score that better discriminates between subjects with or without sensitive skin.

Patients/methods

Among the adult volunteers included in this observational, cross‐sectional study, both LAST‐positive subjects, who were considered as having sensitive skin (“patients”), and negative ones (“controls”) completed the questionnaire. It consisted of a part for self‐assessing and quantifying (0–10) sensitive skin and another one that included 10 items, each referring to a specific, potentially triggering stimulus. A cumulative score (questionnaire‐based skin sensitivity score, 0–10) was calculated from the sum of all items considered capable of triggering unpleasant skin sensations in real‐life experience.

Results

One hundred and sixty‐two subjects were enrolled, 102 patients and 60 controls; 98 subjects thought they had sensitive skin. The mean questionnaire‐based skin sensitivity score was significantly higher among patients than controls and correlated with skin sensitivity self‐assessments. A cutoff value of 3 was set for the identification of LAST‐positive subjects, with 79% accuracy.

Conclusions

The study self‐assessment questionnaire seems to be a reliable tool for diagnosing sensitive skin in clinical practice. These results led us to identify a numerical cutoff for detecting propensity to experience sensitive skin.