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Gergely LH, Gáspár K, Brodszky V, Kinyó Á, Szegedi A, Remenyik É, Kiss NF, Bató A, Péntek M, Gulácsi L, Sárdy M, Bánvölgyi A, Wikonkál N, Rencz F. Validity of EQ-5D-5L, Skindex-16, DLQI and DLQI-R in patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol 2020; 34:2584-2592. [PMID: 32618022 DOI: 10.1111/jdv.16642] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/30/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Numerous generic, skin- and disease-specific health-related quality of life (HRQoL) measures are available for patients with hidradenitis suppurativa (HS). Yet, robust psychometric evidence is lacking in many aspects of these outcome measures. OBJECTIVES We sought to determine convergent and known-groups validity of multiple generic and skin-specific HRQoL measures and to identify predictors of impaired HRQoL in patients with HS. METHODS Between 2017 and 2019, a multicentre cross-sectional study was carried out involving 200 consecutive HS patients. HRQoL outcomes included the EQ-5D-5L, EQ visual analogue scale (EQ VAS), Skindex-16, Dermatology Life Quality Index (DLQI) and DLQI-Relevant (DLQI-R). Disease severity was graded by HS-Physician's Global Assessment (HS-PGA) scale and the Modified Sartorius scale (MSS). RESULTS Overall, 77%, 56%, 51%, 46% and 28% reported problems in the pain/discomfort, usual activities, anxiety/depression, mobility and self-care dimensions of EQ-5D-5L. Mean ± SD EQ VAS, DLQI and DLQI-R scores were 64.29 ± 22.68, 11.75 ± 8.11 and 12.19 ± 8.33, respectively. Skindex-16 responses indicated that the emotional burden of HS (64.55 ± 29.28) far exceeded those of functioning (49.40 ± 34.70) and physical symptoms (46.74 ± 29.36). EQ-5D-5L, EQ VAS, DLQI, DLQI-R and Skindex-16 total scores had moderate or strong correlations with each other (range: |0.487| to |0.993|), weak or moderate correlations with HS-PGA (|0.350| to |0.433|) and weak correlations with MSS (|0.324| to |0.389|). DLQI-R slightly outperformed DLQI both in terms of convergent and known-groups validity. Being female, lower education level, more severe disease and genital involvement were associated with worse HRQoL (P < 0.05). CONCLUSION This study provides high-quality evidence that among skin-specific outcomes, the DLQI, DLQI-R and Skindex-16, and among generic instruments, the EQ-5D-5L are suitable to be used in HS patients. In future research, we recommend the use of existing well-validated HRQoL tools instead of developing new measures for each study. The development of composite measures that combine physician- and patient-reported outcomes is not supported by evidence in HS. [Correction added on 25 July 2020, after first online publication: in the Abstract section, the ± signs were missing and have been added to this version.].
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Affiliation(s)
- L H Gergely
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - K Gáspár
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs Medical School, Pécs, Hungary
| | - A Szegedi
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - É Remenyik
- Departments of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - N F Kiss
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - A Bató
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - A Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - N Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - F Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Premium Postdoctoral Research Programme, Hungarian Academy of Sciences, Budapest, Hungary
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Rencz F, Gergely L, Wikonkál N, Gáspár K, Péntek M, Gulácsi L, Tamási B, Poór A, Kinyó Á, Bali G, Hidvégi B, Sárdy M, Hajdu K, Szegedi A, Remenyik É, Bata‐Csörgő Z, Holló P, Baji P, Brodszky V. Dermatology Life Quality Index (DLQI) score bands are applicable to DLQI‐Relevant (DLQI‐R) scoring. J Eur Acad Dermatol Venereol 2020; 34:e484-e486. [DOI: 10.1111/jdv.16398] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
- Hungarian Academy of Sciences Premium Postdoctoral Research Programme Budapest Hungary
| | - L.H. Gergely
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - N. Wikonkál
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - K. Gáspár
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - B. Tamási
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - Á. Kinyó
- Department of Dermatology, Venereology and Oncodermatology University of Pécs Medical School Pécs Hungary
| | - G. Bali
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - B. Hidvégi
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - K. Hajdu
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - A. Szegedi
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
- Department of Dermatological Allergology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - É. Remenyik
- Departments of Dermatology Faculty of Medicine University of Debrecen Debrecen Hungary
| | - Z. Bata‐Csörgő
- Department of Dermatology and Allergology Albert Szent‐Györgyi Medical Centre University of Szeged Szeged Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Budapest Hungary
| | - P. Baji
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Budapest Hungary
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3
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Rencz F, Gulácsi L, Péntek M, Szegedi A, Remenyik É, Bata‐Csörgő Z, Bali G, Hidvégi B, Tamási B, Poór A, Hajdu K, Holló P, Kinyó Á, Sárdy M, Brodszky V. DLQI‐R scoring improves the discriminatory power of the Dermatology Life Quality Index in patients with psoriasis, pemphigus and morphea. Br J Dermatol 2019; 182:1167-1175. [DOI: 10.1111/bjd.18435] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2019] [Indexed: 02/06/2023]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
- Hungarian Academy of Sciences Premium Postdoctoral Research Programme Nádor u 7 H‐1051 Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - A. Szegedi
- Department of Dermatological AllergologyFaculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
- Department of Dermatology Faculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
| | - É. Remenyik
- Department of Dermatology Faculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
| | - Z. Bata‐Csörgő
- Department of Dermatology and Allergology Albert Szent‐Györgyi Medical Centre University of Szeged Korányi fasor 6 H‐6720 Szeged Hungary
| | - G. Bali
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - B. Hidvégi
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - B. Tamási
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - K. Hajdu
- Department of Dermatological AllergologyFaculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
- Department of Dermatology Faculty of Medicine University of Debrecen Nagyerdei krt 98 H‐4032 Debrecen Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - Á. Kinyó
- Department of Dermatology, Venereology and Oncodermatology University of Pécs Akác u 1 H‐7632 Pécs Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Faculty of Medicine Semmelweis University Mária u 41 H‐1085 Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
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Hegedus C, Boros G, Janka E, Fidrus E, Juhász T, Karikó K, Emri G, Bai P, Remenyik É. 550 In vitro delivery of CPD-specific photolyase-encoding mRNA prevents UVB-induced mitochondrial changes. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Fidrus E, Boros G, Hegedus C, Janka E, Emri G, Karikó K, Remenyik É. 561 Time-dependence of UVB induced cellular mechanisms in cultured human keratinocytes. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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6
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Fidrus E, Fehér P, Hegedus C, Janka E, Paragh G, Bácskay I, Remenyik É. 562 Enhanced UVA-induced cyclobutane pyrimidine dimer formation by silymarin without increased mutagenesis in cultured epithelial cells. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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7
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Janka E, Ványai B, Várvölgyi T, Remenyik É, Emri G. 514 Change of laboratory parameters during anti-PD1 treatment in patients with melanoma. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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8
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Rencz F, Brodszky V, Gulácsi L, Péntek M, Poór A, Holló P, Szegedi A, Remenyik É, Sárdy M, Langenbruch A, Radtke M, Gutknecht M, Augustin M. Time to revise the Dermatology Life Quality Index scoring in psoriasis treatment guidelines. J Eur Acad Dermatol Venereol 2019; 33:e267-e269. [DOI: 10.1111/jdv.15537] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- F. Rencz
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
- Premium Postdoctoral Research Programme Hungarian Academy of Sciences Nádor u. 7 H‐1051 Budapest Hungary
| | - V. Brodszky
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - L. Gulácsi
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - M. Péntek
- Department of Health Economics Corvinus University of Budapest Fővám tér 8 H‐1093 Budapest Hungary
| | - A.K. Poór
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - P. Holló
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - A. Szegedi
- Departments of Dermatology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
- Department of Dermatological Allergology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
| | - É. Remenyik
- Departments of Dermatology University of Debrecen Nagyerdei krt. 98 H‐4032 Debrecen Hungary
| | - M. Sárdy
- Department of Dermatology, Venereology and Dermatooncology Semmelweis University Mária u. 41 H‐1085 Budapest Hungary
| | - A. Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M.A. Radtke
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M. Gutknecht
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP) University Medical Center Hamburg‐Eppendorf (UKE) Martinistraße 52 20246 Hamburg Germany
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9
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Rencz F, Gulácsi L, Péntek M, Poór A, Sárdy M, Holló P, Szegedi A, Remenyik É, Brodszky V. Proposal of a new scoring formula for the DLQI in psoriasis. Br J Dermatol 2018. [DOI: 10.1111/bjd.17214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rencz F, Gulácsi L, Péntek M, Poór AK, Sárdy M, Holló P, Szegedi A, Remenyik É, Brodszky V. 银屑病中 DLQI 新评分公式的提议. Br J Dermatol 2018. [DOI: 10.1111/bjd.17228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rencz F, Gulácsi L, Péntek M, Poór AK, Sárdy M, Holló P, Szegedi A, Remenyik É, Brodszky V. Proposal of a new scoring formula for the Dermatology Life Quality Index in psoriasis. Br J Dermatol 2018; 179:1102-1108. [PMID: 29968311 DOI: 10.1111/bjd.16927] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND 'Not relevant' responses (NRRs) on the Dermatology Life Quality Index (DLQI) may occur in up to 40% of patients with psoriasis. As these responses are scored as the item of the questionnaire having no impact on the patients' lives at all, it is more difficult for these patients to fulfil the DLQI > 10 criterion required by clinical guidelines to become candidates for systemic treatment including biologics. OBJECTIVES We propose a new scoring system for the DLQI that corrects for the bias in the NRR option and test its construct validity in a sample of patients with psoriasis. METHODS Data from 242 patients (104 of whom marked at least one NRR) from two earlier cross-sectional surveys were reanalysed. For each patient, the DLQI score was calculated in two ways: (i) according to the original scoring and (ii) by applying a new scoring formula (DLQI-R) that adjusts the total score for the number of NRRs. The construct validity of the DLQI-R was tested against the Psoriasis Area and Severity Index (PASI) and EQ-5D-3L. RESULTS The mean DLQI and DLQI-R scores were 9·99 ± 7·52 and 11·0 ± 8·02, respectively. The DLQI-R allowed eight more patients (3·3%) to achieve the 'PASI > 10 and DLQI > 10' threshold. The results were robust when limiting the maximum number of NRRs allowed to two or three. Compared with the DLQI, DLQI-R correlated slightly better with PASI (rs = 0·59 vs. 0·57) and EQ-5D-3L index scores (rs = -0·58 vs. -0·54). CONCLUSIONS The DLQI-R seems to be a valid scoring system for avoiding the bias in the NRR option and can help to improve patients' access to biologics.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Programme, Nádor u. 7, H-1051, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
| | - A K Poór
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - P Holló
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, Mária u. 41, H-1085, Budapest, Hungary
| | - A Szegedi
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary.,Department of Dermatological Allergology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - É Remenyik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, H-4032, Debrecen, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary
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Rencz F, Poór AK, Péntek M, Holló P, Kárpáti S, Gulácsi L, Szegedi A, Remenyik É, Hidvégi B, Herszényi K, Jókai H, Beretzky Z, Brodszky V. A detailed analysis of 'not relevant' responses on the DLQI in psoriasis: potential biases in treatment decisions. J Eur Acad Dermatol Venereol 2017; 32:783-790. [PMID: 29114942 DOI: 10.1111/jdv.14676] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 10/16/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Dermatology Life Quality Index (DLQI) is the most common health-related quality of life measure in dermatology that is widely used in treatment guidelines for psoriasis. Eight of the 10 questions of the DLQI offer a 'not relevant' response (NRR) option that is scored as the item had no impact on patients' life at all. OBJECTIVE To explore the occurrence of NRRs on the DLQI in psoriasis patients and to examine the effect of several socio-demographic and clinical factors on giving NRRs. METHODS Data were obtained from two cross-sectional surveys among psoriasis patients at two academic dermatology clinics in Hungary. Health-related quality of life was measured by employing DLQI and EQ-5D-3L, while disease severity was graded by Psoriasis Area and Severity Index (PASI). Multivariate logistic regression was applied to determine the predictors of providing NRRs. RESULTS Mean age of the 428 patients was 49 years, and 65% were males. Mean PASI, DLQI and EQ-5D-3L index scores were 8.4 ± 9.5, 6.8 ± 7.4 and 0.74 ± 0.28, respectively. Overall, 38.8% of the patients had at least one NRR: 19.6% (one), 11.5% (two), 5.1% (three) and 2.6% (more than three). Most NRRs occurred in sport, sexual difficulties and working/studying items of the DLQI (28.4%, 16.4% and 14.0%, respectively). Female gender (OR 1.65; 95% CI 1.04-2.61), older age (OR 1.05; 95% CI 1.03-1.07) and higher PASI score (OR 1.03; 95% CI 1.01-1.06) were associated with providing more NRRs, whereas highly educated patients (OR 0.34; 95% CI 0.16-0.72) and those with a full-time job (OR 0.47; 95% CI 0.29-0.77) less frequently tended to tick NRRs. CONCLUSION The high rate of psoriasis patients with NRRs, especially among women, less educated and elderly patients, indicates a content validity problem of the measure. A reconsideration of the use of the DLQI for medical and financial decision-making in psoriasis patients is suggested.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - A K Poór
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - P Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - S Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - A Szegedi
- Department of Dermatology, University of Debrecen, Debrecen, Hungary.,Department of Dermatological Allergology, University of Debrecen, Debrecen, Hungary
| | - É Remenyik
- Department of Dermatology, University of Debrecen, Debrecen, Hungary
| | - B Hidvégi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - K Herszényi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - H Jókai
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Z Beretzky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Doctoral School of Business and Management, Corvinus University of Budapest, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
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Janka E, Kékedi K, Gellén E, Remenyik É, Emri G. 600 Trends in incidence and tumour thickness of invasive cutaneous melanoma from 2000 to 2014 in an Eastern Hungarian melanoma centre. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Péter M, Boros G, Hegedüs C, Fidrus E, Emri G, Karikó K, Remenyik É. 637 Time-dependent investigation of UVB-induced cellular mechanisms in human keratinocytes using mRNA encoding cyclobutane pyrimidine dimer-specific photolyase. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rencz F, Poór A, Péntek M, Holló P, Kárpáti S, Gulácsi L, Szegedi A, Remenyik É, Hidvégi B, Brodszky V. 017 Women, elderly and less educated psoriasis patients provide more ‘not relevant’ responses on the Dermatology Life Quality Index - is it a problem? J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Hegedüs C, Boros G, Janka E, Lovászi M, Karikó K, Juhász T, Kis G, Emri G, Bai P, Remenyik É. 620 Poly(ADP-ribose) polymerase-1 activity modulates mitochondrial function following UVB irradiation. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Kovacs D, Lovászi M, Zouboulis C, Bíró T, Oláh A, Ståhle M, Remenyik É, Töröcsik D. 414 Identification of sebocytes as a novel source for adipokines within human skin. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Janka E, Töröcsik D, Gáspár K, Bodnár E, Sawhney I, Csordás A, Kovács Z, Herédi E, Szegedi A, Remenyik É. 041 The association between early-onset and late-onset psoriasis and co-morbidities in a case-control study. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Gellén E, Sántha O, Janka E, Juhász I, Péter Z, Erdei I, Lukács R, Fedinecz N, Galuska L, Remenyik É, Emri G. Diagnostic accuracy of (18)F-FDG-PET/CT in early and late stages of high-risk cutaneous malignant melanoma. J Eur Acad Dermatol Venereol 2015; 29:1938-44. [PMID: 25753249 DOI: 10.1111/jdv.13084] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 01/27/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND The precise role of total body (18) F-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) in the clinical management of patients with cutaneous malignant melanoma (CMM) is not well established. OBJECTIVE The purpose of this study was to investigate the diagnostic accuracy of PET/CT in early- and late-stage patients with high-risk CMM. METHODS We retrospectively analysed various imaging, histopathological and clinical data from 97 patients also examined by PET/CT during a 5-year period (2007-2011). Three groups were assessed: stage I/II, resected stage III and unresectable stage III/stage IV. RESULTS The median follow-up time of living patients was 43.48 ± 19.67 (15-142) months. We observed a high diagnostic accuracy in all stages (91.3%, 92.5% and 96.2% respectively). PET/CT appeared to be reliable diagnostic tool even for the detection of small lymph node metastases. PET/CT was informative in 14 of 19 cases wherein another imaging examination provided inconclusive results regarding lesion dignity. However, PET/CT was less suitable for properly evaluating the dignity of a lung lesion. A true positive scan was twice as likely in clinically negative patients with resected stage III disease than in patients with stage I/II disease (35.9% and 14.5%, P = 0.007). CONCLUSIONS These results confirm that PET/CT is an important diagnostic tool in the management of patients with high-risk CMM, but it cannot replace the standard of care examinations. More accurate clinicopathological and timing criteria must be defined to best utilize the advantages of this imaging method.
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Affiliation(s)
- E Gellén
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - O Sántha
- Scanomed Ltd., Debrecen, Hungary
| | - E Janka
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - I Juhász
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Z Péter
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - I Erdei
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - R Lukács
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | | | - L Galuska
- Department of Nuclear Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - É Remenyik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - G Emri
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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20
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Rencz F, Holló P, Kárpáti S, Péntek M, Remenyik É, Szegedi A, Balogh O, Herédi E, Herszényi K, Jókai H, Brodszky V, Gulácsi L. Moderate to severe psoriasis patients' subjective future expectations regarding health-related quality of life and longevity. J Eur Acad Dermatol Venereol 2014; 29:1398-405. [PMID: 25491660 DOI: 10.1111/jdv.12884] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 10/28/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Unrealistic expectations regarding treatments and clinical outcomes may lead to disappointment about therapy and sub-optimal compliance; nonetheless, these expectations have not been studied in psoriasis patients yet. OBJECTIVE To evaluate psoriasis patients' subjective future expectations regarding health-related quality of life (HRQOL) and life expectancy, and to explore clinical features associated with under- or overestimating behaviour. METHODS A cross-sectional questionnaire survey of consecutive adult patients with moderate to severe psoriasis was conducted. HRQOL expectations were recorded by applying the EQ-5D descriptive system for 6 months ahead and for future ages of 60, 70, 80 and 90 respectively. RESULTS In total, 167 patients (71% males) were included in the analysis with mean age of 50.4 ± 12.4 years and mean EQ-5D score of 0.71 ± 0.30. Overall 65% had chronic plaque psoriasis, 35% nail psoriasis, 35% scalp involvement, 29% psoriatic arthritis, 9% inverse psoriasis and 5% palmoplantar psoriasis respectively (combinations occurred). Participants expected 0.1 ± 0.23 mean improvement in EQ-5D within 6 months (P < 0.001) that achieves the minimum clinically important difference. Overall 37% expected improvement and 13% decline; however, 49% expected no changes in any of the five dimensions of EQ-5D within 6 months. Female gender, inverse or palmoplantar involvement and more severe psoriasis were likely associated with higher expectations. Patients at the initiation of their first biological at the time of the survey expected 0.18 ± 0.24 increase that seems to be realistic compared to the EQ-5D utility gain achieved in randomized controlled trials. Males expected by 2.7 ± 11.1 more, while females expected by 5.2 ± 9.3 less life years compared to the average statistical gender- and age-matched life expectancy (P < 0.05). Patients who expected to be alive at ages of 60, 70, 80 and 90 scored their future EQ-5D at ages of 60 to 90: 0.59 ± 0.46, 0.48 ± 0.41, 0.42 ± 0.41 and 0.22 ± 0.47 respectively. CONCLUSION Our findings highlight the importance of exploring expectations that might help to increase patients' compliance.
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Affiliation(s)
- F Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.,Semmelweis University Doctoral School of Clinical Medicine, Budapest, Hungary
| | - P Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - S Kárpáti
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - M Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - É Remenyik
- Departments of Dermatology and Dermatological Allergology, University of Debrecen, Debrecen, Hungary
| | - A Szegedi
- Departments of Dermatology and Dermatological Allergology, University of Debrecen, Debrecen, Hungary
| | - O Balogh
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - E Herédi
- Departments of Dermatology and Dermatological Allergology, University of Debrecen, Debrecen, Hungary
| | - K Herszényi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - H Jókai
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - V Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - L Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
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Törőcsik D, Kovács D, Camera E, Lovászi M, Cseri K, Nagy GG, Molinaro R, Rühl R, Tax G, Szabó K, Picardo M, Kemény L, Zouboulis CC, Remenyik É. Leptin promotes a proinflammatory lipid profile and induces inflammatory pathways in human SZ95 sebocytes. Br J Dermatol 2014; 171:1326-35. [PMID: 24975960 DOI: 10.1111/bjd.13229] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2014] [Indexed: 12/24/2022]
Abstract
BACKGROUND Leptin, the adipocyte-secreted hormone that regulates weight, is known to link lipid metabolism with inflammation in various cell types. However, its role in human sebocytes has not yet been investigated. OBJECTIVES The purpose of this study was to investigate the effects of leptin in human sebaceous gland biology. METHODS Expression of the long form of the leptin receptor (Ob-Rb) was detected by real-time quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and immunochemistry. Lipid analysis was by high-performance thin-layer chromatography, gas chromatography-mass spectrometry and time-of-flight mass spectrometer mass detection. Lipid bodies were visualized by BODIPY staining using fluorescent microscopy and measured by flow cytometry. Interleukin (IL)-6 and IL-8 mRNA levels were assessed by real-time qRT-PCR and their release was evaluated by enzyme-linked immunosorbent assay. Cyclooxygenase (COX)-2 and 5-lipooxygenase (LOX) protein expression and phosphorylation of p65 and signal transducer and activator of transcription (STAT)-3 were determined by Western blot analysis. RESULTS Expression of Ob-Rb was detected in human sebaceous glands and in cultured human SZ95 sebocytes. The treatment of SZ95 sebocytes with leptin led to enlarged intracellular lipid bodies, increased ratios of unsaturated/saturated fatty acids and decreased vitamin E levels. Further supporting a proinflammatory role, leptin induced COX-2 and 5-LOX expression in SZ95 sebocytes and augmented the production of IL-6 and IL-8 cytokines. On leptin treatment, the STAT-3 and nuclear factor-κB pathways were activated, indicating that these known leptin signalling pathways are active in human sebocytes. CONCLUSIONS Our findings suggest that leptin signalling may be involved in the proinflammatory regulation of sebaceous lipid metabolism and the induction of inflammatory enzymes and cytokines.
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Affiliation(s)
- D Törőcsik
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Nagyerdei krt. 98, Debrecen, H4032, Hungary
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Rencz F, Gulacsi L, Remenyik É, Szegedi A, Holló P, Kárpáti S, Péntek M, Brodszky V. Subjective Expectations Regarding Life Expectancy And Health-Related Quality Of Life In Moderate To Severe Psoriasis Patients. Value Health 2014; 17:A611. [PMID: 27202132 DOI: 10.1016/j.jval.2014.08.2142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- F Rencz
- Corvinus University of Budapest, Budapest, Hungary
| | - L Gulacsi
- Corvinus University of Budapest, Budapest, Hungary
| | - É Remenyik
- University of Debrecen, Debrecen, Hungary
| | - A Szegedi
- University of Debrecen, Debrecen, Hungary
| | - P Holló
- Semmelweis University, Budapest, Hungary
| | - S Kárpáti
- Semmelweis University, Budapest, Hungary
| | - M Péntek
- Corvinus University of Budapest, Budapest, Hungary
| | - V Brodszky
- Corvinus University of Budapest, Budapest, Hungary
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Miltenyi Z, Gonda A, Tar I, Remenyik É, Illés Á. P155 Paraneoplastic pemphigus vulgaris with Castleman disease and successful immunomodulatory therapy. Blood Rev 2007. [DOI: 10.1016/s0268-960x(07)70234-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Harangi M, Remenyik É, Seres I, Varga Z, Balogh Z, Paragh G. Determination of DNA damage induced by oxidative stress in hyperlipidemic patients using comet assay. ATHEROSCLEROSIS SUPP 2001. [DOI: 10.1016/s1567-5688(01)80343-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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