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Javvaji CK, Vagha JD, Meshram RJ, Taksande A. Assessment Scales in Cerebral Palsy: A Comprehensive Review of Tools and Applications. Cureus 2023; 15:e47939. [PMID: 38034189 PMCID: PMC10685081 DOI: 10.7759/cureus.47939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/28/2023] [Indexed: 12/02/2023] Open
Abstract
Cerebral palsy (CP) is a complex neurological condition characterized by motor dysfunction affecting millions worldwide. This comprehensive review delves into the critical role of assessment in managing CP. Beginning with exploring its definition and background, we elucidate the diverse objectives of CP assessment, ranging from diagnosis and goal setting to research and epidemiology. We examine standard assessment scales and tools, discuss the challenges inherent in CP assessment, and highlight emerging trends, including integrating technology, personalized medicine, and neuroimaging. The applications of CP assessment in clinical diagnosis, treatment planning, research, and education are underscored. Recommendations for the future encompass standardization, interdisciplinary collaboration, research priorities, and professional training. In conclusion, we emphasize the importance of assessment as a compass guiding the care of individuals with CP, issuing a call to action for improved assessment practices to shape a brighter future for those affected by this condition.
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Affiliation(s)
- Chaitanya Kumar Javvaji
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jayant D Vagha
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Revat J Meshram
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amar Taksande
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Sansone L, Gentile C, Grasso EA, Di Ludovico A, La Bella S, Chiarelli F, Breda L. Pain Evaluation and Treatment in Children: A Practical Approach. Children (Basel) 2023; 10:1212. [PMID: 37508709 PMCID: PMC10378137 DOI: 10.3390/children10071212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
Pain is the most common complaint reported by children who access the emergency departments, but despite its frequency and the availability of many international guidelines, it often remains underreported and undertreated. Recently, the American Academy of Pediatrics and the American Pain Society have reiterated the importance of a multidisciplinary approach in order to eliminate pain in children. In all pediatric settings, an adequate assessment is the initial stage in a proper clinical approach to pain, especially in the emergency departments; therefore, an increasing number of age-related tools have been validated. A wide range of analgesic agents are currently available for pain management, and they should be tailored according to the patient's age, the drug's pharmacokinetics and the intensity of pain. In order to facilitate the choice of the appropriate drug, a treatment algorithm based on a ladder approach can be used. Moreover, non-pharmacological techniques should be considered to alleviate anxiety and distress in pediatric age. This review aims to offer a simple but intuitive description of the best strategies for pain relief in children, starting with the prompt recognition and quantification of pain through adequate assessment scales, and following with the identification of the most appropriate therapeutic choice among the ones available for pediatric age.
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Affiliation(s)
- Lorenzo Sansone
- Department of Pediatrics, University "G. D'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
| | - Cristina Gentile
- Department of Pediatrics, University "G. D'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
| | - Eleonora Agata Grasso
- Department of Pediatrics, University "G. D'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
| | - Armando Di Ludovico
- Department of Pediatrics, University "G. D'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
| | - Saverio La Bella
- Department of Pediatrics, University "G. D'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
| | - Francesco Chiarelli
- Department of Pediatrics, University "G. D'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
| | - Luciana Breda
- Department of Pediatrics, University "G. D'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy
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Bernetti A, Ruggiero M, Ruiu P, Napoli M, D’Urzo R, Mancuso A, Mariani F, Tota L, Agostini F, Mangone M, Paoloni M. Analysis and Report of the Physical and Rehabilitation Medicine Evaluation Activity in Patients Admitted to Acute Care Setting: An Observational Retrospective Study. Int J Environ Res Public Health 2023; 20:6039. [PMID: 37297646 PMCID: PMC10252334 DOI: 10.3390/ijerph20116039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/01/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Disability (both temporary and transitory, or definitive) might occur for the first time in a given patient after an acute clinical event. It is essential, whenever indicated, to undergo a Physical Medicine and Rehabilitation assessment to detect disability and any need for rehabilitation early. Although access to rehabilitation services varies from country to country, it should always be governed by a PRM prescription. OBJECTIVE The aim of the present observational retrospective study is to describe consultancy activity performed by PRM specialists in a university hospital in terms of requests' typology, clinical questions, and rehabilitation setting assignment. METHODS Multiple parameters were analyzed (clinical condition, patient's socio-family background, and rehabilitation assessment scale scores) and a correlation analysis was performed between the analyzed characteristics and both the different clinical conditions and the assigned rehabilitation setting. RESULTS PRM evaluations of 583 patients from 1 May 2021 to 30 June 2022 were examined. Almost half of the total sample (47%) presented disability due to musculoskeletal conditions with a mean age of 76 years. The most frequently prescribed settings were home rehabilitation care, followed by intensive rehabilitation and long-term care rehabilitation. CONCLUSIONS Our results suggest the high public health impact of musculoskeletal disorders, followed by neurological disorders. This is, however, without forgetting the importance of early rehabilitation to prevent other types of clinical conditions such as cardiovascular, respiratory, or internal diseases from leading to motor disability and increasing costs.
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Affiliation(s)
- Andrea Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Marco Ruggiero
- Physical and Rehabilitation Medicine, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Pierangela Ruiu
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Martina Napoli
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Rossella D’Urzo
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Annalisa Mancuso
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Flavio Mariani
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Luigi Tota
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Massimiliano Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy
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Abdul Kadir NB, Ismail WNK, Abdullah NA, Helma R, Abdul Jalil SJ, Che Kasim A, Hoesni SM, Manaf MRA. Criterion Validity and Psychometric Properties of a Malay Version of the Short Multidimensional Inventory Lifestyle Evaluation-Confinement (SMILE-C) in a Sample of University Staff with Weight Problems. Int J Environ Res Public Health 2021; 18:10410. [PMID: 34639710 DOI: 10.3390/ijerph181910410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 12/23/2022]
Abstract
The aim of this study was to validate the Short Multidimensional Inventory Lifestyle Evaluation-Confinement (SMILE-C) in a Malaysian context. The SMILE-C, which is a respondent-generated instrument, was used to ask participants questions on their lifestyle during the COVID-19 pandemic. The indices of seven sub-scores were then calculated. A total of 121 university staff members completed the Malay version of the SMILE-C as well as instruments for measuring well-being, family life satisfaction, mindfulness and awareness, work engagement, and quality of life. The Cronbach’s alpha values and Pearson correlation coefficients were satisfactory in this initial validation of the instrument. The SMILE-C showed positive correlations with all the variables being studied. The results supported the criterion-related validity and psychometric properties of the Malay version of the SMILE-C as an instrument for assessing lifestyle changes during the COVID-19 pandemic.
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Markowitz JT, Oberdhan D, Ciesluk A, Rams A, Wigal SB. Review of Clinical Outcome Assessments in Pediatric Attention-Deficit/Hyperactivity Disorder. Neuropsychiatr Dis Treat 2020; 16:1619-1643. [PMID: 32669845 PMCID: PMC7335865 DOI: 10.2147/ndt.s248685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 05/28/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Various clinical outcome assessments (COAs) are used in clinical research to assess and monitor treatment efficacy in pediatric attention-deficit/hyperactivity disorder (ADHD) trials. It is unclear whether the concepts assessed are those that are important to patients and their caregivers. The concepts measured by commonly used COAs in this population have not been explicitly compared. METHODS We conducted reviews of the qualitative literature to extract information on pediatric ADHD-related concepts reported by pediatric patients, parents, and teachers. Using these concepts, we developed a conceptual framework of pediatric ADHD using both the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria and the additional symptoms and behavioral impacts identified in the literature. We searched for COAs that have been used in pediatric ADHD research and mapped their items based on their conceptual underpinning. RESULTS Of the 27 COAs found in the empirical literature, 4 COAs assessed only DSM symptoms. The most comprehensive coverage of our conceptual framework was seen in the Swanson, Nolan, and Pelham Rating Scale-DSM-IV (SNAP-IV). Eighteen COAs were used in at least 1 clinical trial: ADHD-Rating Scale-IV (ADHD-RS-IV) was used most often (n=77), followed by SNAP-IV (n=50), Swanson, Kotkin, Agler, M-Flynn, and Pelham Scale (SKAMP; n=31), Weiss Functional Impairment Rating Scale (WFIRS; n=24), and Vanderbilt ADHD Diagnostic Rating Scale (VADRS; n=15). CONCLUSION We identified symptoms and behavioral impacts from qualitative studies in pediatric ADHD that are not included in DSM-based criteria. Most COAs used in pediatric ADHD clinical trials measure only those symptoms listed in the DSM. While these COAs can measure symptom severity, they may not assess the full range of symptoms and impacts important to patients and their caregivers. Future research is needed to measure all concepts important to patients and caregivers within ADHD clinical trials.
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Affiliation(s)
| | - Dorothee Oberdhan
- HEOR and Outcomes Management, Otsuka America Pharmaceutical, Inc, Rockville, MD20850, USA
| | - Anna Ciesluk
- Research Department, Modus Outcomes, Cambridge, MA02142, USA
| | - Alissa Rams
- Research Department, Modus Outcomes, Cambridge, MA02142, USA
| | - Sharon B Wigal
- Department of Pediatrics, University of California School of Medicine, Irvine, CA92697–4089, USA
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Dolenc E, Rotar-Pavlič D. Frailty Assessment Scales for the Elderly and their Application in Primary Care: A Systematic Literature Review. Zdr Varst 2019; 58:91-100. [PMID: 30984300 DOI: 10.2478/sjph-2019-0012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 02/22/2019] [Indexed: 01/12/2023] Open
Abstract
Background The increase in the elderly population is causing changes and challenges that demand a comprehensive public health response. A specific characteristic of the elderly is their frailty. Today’s problems with identifying levels of frailty are being resolved by numerous tools in the form of frailty assessment scales. This systematic review establishes which frailty assessment scales for the elderly are being used and what their applicability in primary care is like in Slovenia and around the world. Methods Documents published after 2010 were searched for in the PubMed database using keywords and other specific criteria. Results A total of 177 search hits were obtained based on various search strings. The final analysis included 28 articles, of which three were systematic literature reviews. These three covered quantitative studies, mainly consisting of observational cross-sectional surveys or cohort studies. Three other studies featured non-systematic literature reviews. Quantitative studies (mainly cross-sectional surveys or cohort studies) prevailed among the remaining 22 articles. One study had a qualitative design (Delphi method). The main outcome measures observed by all studies were frailty assessment scales for the elderly, the majority of which were evaluated on a sample of the elderly. Conclusions None of the assessment scales examined are used as the gold standard for primary care. A variety of tools are being used in clinical practice to assess frailty in elderly patients, highlighting the need for standardization and guidelines. This requires evaluating the current assessment scales in terms of validity and reliability, and suitably improving them.
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Schultz-Darken N, Braun KM, Emborg ME. Neurobehavioral development of common marmoset monkeys. Dev Psychobiol 2015; 58:141-58. [PMID: 26502294 DOI: 10.1002/dev.21360] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 09/07/2015] [Indexed: 11/06/2022]
Abstract
Common marmoset (Callithrix jacchus) monkeys are a resource for biomedical research and their use is predicted to increase due to the suitability of this species for transgenic approaches. Identification of abnormal neurodevelopment due to genetic modification relies upon the comparison with validated patterns of normal behavior defined by unbiased methods. As scientists unfamiliar with nonhuman primate development are interested to apply genomic editing techniques in marmosets, it would be beneficial to the field that the investigators use validated methods of postnatal evaluation that are age and species appropriate. This review aims to analyze current available data on marmoset physical and behavioral postnatal development, describe the methods used and discuss next steps to better understand and evaluate marmoset normal and abnormal postnatal neurodevelopment.
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Affiliation(s)
- Nancy Schultz-Darken
- Wisconsin National Primate Research Center, University of Wisconsin, Madison, WI
| | - Katarina M Braun
- Wisconsin National Primate Research Center, University of Wisconsin, Madison, WI.,Medical Scientist Training Program, University of Wisconsin, Madison, WI
| | - Marina E Emborg
- Wisconsin National Primate Research Center, University of Wisconsin, Madison, WI.,Medical Scientist Training Program, University of Wisconsin, Madison, WI.,Department of Medical Physics, University of Wisconsin, Madison, WI
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Abstract
Patients with prolonged disorders of consciousness (PDOC) stemming from acquired brain injury present one of the most challenging clinical populations in neurological rehabilitation. Because of the complex clinical presentation of PDOC patients, treatment teams are confronted with many medicolegal, ethical, philosophical, moral, and religious issues in day-to-day care. Accurate diagnosis is of central concern, relying on creative approaches from skilled clinical professionals using combined behavioral and neurophysiological measures. This paper presents the latest evidence for using music as a diagnostic tool with PDOC, including recent developments in music therapy interventions and measurement. We outline standardized clinical protocols and behavioral measures to produce diagnostic outcomes and examine recent research illustrating a range of benefits of music-based methods at behavioral, cardiorespiratory, and cortical levels using video, electrocardiography, and electroencephalography methods. These latest developments are discussed in the context of evidence-based practice in rehabilitation with clinical populations.
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Affiliation(s)
- Wendy L Magee
- Boyer College of Music and Dance, Temple University, Philadelphia, Pennsylvania
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9
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van der Linde RM, Stephan BCM, Dening T, Brayne C. Instruments to measure behavioural and psychological symptoms of dementia. Int J Methods Psychiatr Res 2014; 23:69-98. [PMID: 24496852 PMCID: PMC6878288 DOI: 10.1002/mpr.1414] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 10/23/2012] [Accepted: 11/26/2012] [Indexed: 11/11/2022] Open
Abstract
Reliable and valid measurement of behavioural and psychological symptoms of dementia (BPSD) is important for research and clinical practice. Here we provide an overview of the different instruments and discuss issues involved in the choice of the most appropriate instrument to measure BPSD in research. A list of BPSD instruments was generated. For each instrument Pubmed and SCOPUS were searched for articles that reported on their use or quality. Eighty-three instruments that are used to measure BPSD were identified. Instruments differ in length and detail, whether the interview is with participants, informants or by observation, the target sample and the time frames for use. Reliability and validity is generally good, but reported in few independent samples. When choosing a BPSD instrument for research the research question should be carefully scrutinised and the symptoms of interest, population, quality, detail, time frame and practical issues should be considered.
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Affiliation(s)
- Rianne M van der Linde
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, UK
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10
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Abstract
INTRODUCTION Prompt administration of antipsychotic treatment that is adhered to is essential for the optimal treatment of schizophrenia. Many patients have benefited from the advent of second-generation antipsychotics, which can offer good symptomatic control with reduced incidence of extrapyramidal symptoms, although with higher risk of metabolic side effects. It is unsurprising that accounts as to whether first- and second-generation antipsychotics differ in their efficacy vary, since treatment effectiveness is a broad notion and difficult to define. OBJECTIVES Numerous factors may be used to gauge treatment effectiveness and, while it has largely been defined in terms of improvements in four domains (symptoms of disease, treatment burden, disease burden, and health and wellness), the real-world clinical utility of this consensus is unclear. Therefore, this article aims to provide a framework that can aid psychiatrists in making assessments about treatment effectiveness. METHODS AND RESULTS A panel of 12 psychiatrists and psychopharmacologists convened to develop and propose an accessible and globally-applicable framework for assessing the effectiveness of antipsychotic treatments in patients with schizophrenia. Following presentation of a preliminary proposal to a wider group of psychiatrists from across Europe, it was refined into a framework comprising five domains: symptomatic remission and retention of treatment; affective symptoms; cognitive functioning; treatment satisfaction; and personal and social functioning - each of which is discussed in this article. CONCLUSIONS This article provides a framework that can aid psychiatrists in making assessments about treatment effectiveness. It is anticipated that the framework outlined here may contribute to improving clinical practice through the promotion of a patient-centered approach to the assessment of treatment effectiveness, using five specified domains, in patients with schizophrenia.
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Affiliation(s)
- Georg Juckel
- Department of Psychiatry, LWL-University Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Andrea de Bartolomeis
- Laboratory of Molecular Psychiatry and Unit of Treatment Resistant Psychosis, University School of Medicine of Naples Federico II, Napoli, Italy
| | - Philip Gorwood
- Groupe Hospitalier Sainte-Anne (CMME), Paris-Descartes University, Paris, France
| | | | - Luca Pani
- Institute of Translational Pharmacology, Italian National Research Council, Rome, Italy
| | | | - Julio Sanjuan
- Clinic Hospital, Spanish Mental Health Network (CIBERSAM), University of Valencia, Valencia, Spain
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Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, Berger TG, Bergman JN, Cohen DE, Cooper KD, Cordoro KM, Davis DM, Krol A, Margolis DJ, Paller AS, Schwarzenberger K, Silverman RA, Williams HC, Elmets CA, Block J, Harrod CG, Smith Begolka W, Sidbury R. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol 2013; 70:338-51. [PMID: 24290431 DOI: 10.1016/j.jaad.2013.10.010] [Citation(s) in RCA: 678] [Impact Index Per Article: 61.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Revised: 10/03/2013] [Accepted: 10/05/2013] [Indexed: 10/26/2022]
Abstract
Atopic dermatitis (AD) is a chronic, pruritic, inflammatory dermatosis that affects up to 25% of children and 2% to 3% of adults. This guideline addresses important clinical questions that arise in the management and care of AD, providing updated and expanded recommendations based on the available evidence. In this first of 4 sections, methods for the diagnosis and monitoring of disease, outcomes measures for assessment, and common clinical associations that affect patients with AD are discussed. Known risk factors for the development of disease are also reviewed.
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Affiliation(s)
- Lawrence F Eichenfield
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, San Diego, California
| | - Wynnis L Tom
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, San Diego, California
| | - Sarah L Chamlin
- Department of Dermatology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Steven R Feldman
- Department of Dermatology, Wake Forest University Health Sciences, Winston-Salem, North Carolina
| | - Jon M Hanifin
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | - Eric L Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | - Timothy G Berger
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - James N Bergman
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - David E Cohen
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Kevin D Cooper
- Department of Dermatology, Case Western University, Cleveland, Ohio
| | - Kelly M Cordoro
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Dawn M Davis
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Alfons Krol
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | - David J Margolis
- Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Amy S Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | | | - Hywel C Williams
- Centre of Evidence-Based Dermatology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Craig A Elmets
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Julie Block
- National Eczema Association, San Rafael, California
| | | | | | - Robert Sidbury
- Department of Dermatology, Seattle Children's Hospital, Seattle, Washington
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