Yong Hyun Jang1, Seok Min Kim2, Dong Hyuk Eun2, Kyung Duck Park2, Gyeong-Hun Park3, Byung-Soo Kim4, Kapsok Li5, Chang Ook Park6, Hye One Kim7, Hei Sung Kim8, Min Soo Jang9, Eun Jin Doh10, Dong Hun Lee10, Yang Won Lee11, Do Won Kim2, Seong-Jin Kim12. 1. Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea. Electronic address: yhjang@knu.ac.kr. 2. Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea. 3. Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea. 4. Pusan National University School of Medicine, Busan, Republic of Korea. 5. Chung-Ang University College of Medicine, Seoul, Republic of Korea. 6. Severance Hospital, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. 7. Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea. 8. Incheon St. Mary's Hospital, Department of Biomedicine & Health Sciences, The Catholic University of Korea, Incheon, Republic of Korea. 9. Kosin University College of Medicine, Busan, Republic of Korea. 10. Seoul National University College of Medicine, Seoul, Republic of Korea. 11. Konkuk University School of Medicine, Seoul, Republic of Korea. 12. Chonnam National University Medical School, Gwangju, Republic of Korea. Electronic address: seongkim@chonnam.ac.kr.
Abstract
BACKGROUND: Several tools can provide a reliable and accurate evaluation of pruritus, including the visual analog scale (VAS), numeric rating scale (NRS), verbal rating scale (VRS), and multidimensional questionnaires such as the Itch Severity Scale (ISS). However, no single method is considered a gold standard. OBJECTIVE: We evaluated the validity and reliability of VAS, NRS, VRS, and ISS and their correlation with a pruritus-specific quality of life instrument, ItchyQoL. METHODS: A total of 419 patients (215 men and 204 women) with chronic pruritus (mean age, 46.58 years) recorded their pruritus intensity on VAS, NRS, VRS, and ISS. Retest reliability was analyzed in a second assessment 3 hours after the initial assessment. All participants answered ItchyQoL. RESULTS: A strong correlation between VAS, NRS, and VRS was found. ISS showed a low intercorrelation validity with these tools. However, ISS was more strongly correlated with ItchyQoL. The retest reliability scores were similar for VAS, NRS, and VRS but lower than the scores obtained for ISS. LIMITATIONS: Limitations include patient heterogeneity and recall bias. CONCLUSION: The assessment of pruritus is challenging because of the subjective symptoms and the multifactorial nature. Therefore, more studies are needed to determine the best strategy to assess itch intensity.
BACKGROUND: Several tools can provide a reliable and accurate evaluation of pruritus, including the visual analog scale (VAS), numeric rating scale (NRS), verbal rating scale (VRS), and multidimensional questionnaires such as the Itch Severity Scale (ISS). However, no single method is considered a gold standard. OBJECTIVE: We evaluated the validity and reliability of VAS, NRS, VRS, and ISS and their correlation with a pruritus-specific quality of life instrument, ItchyQoL. METHODS: A total of 419 patients (215 men and 204 women) with chronic pruritus (mean age, 46.58 years) recorded their pruritus intensity on VAS, NRS, VRS, and ISS. Retest reliability was analyzed in a second assessment 3 hours after the initial assessment. All participants answered ItchyQoL. RESULTS: A strong correlation between VAS, NRS, and VRS was found. ISS showed a low intercorrelation validity with these tools. However, ISS was more strongly correlated with ItchyQoL. The retest reliability scores were similar for VAS, NRS, and VRS but lower than the scores obtained for ISS. LIMITATIONS: Limitations include patient heterogeneity and recall bias. CONCLUSION: The assessment of pruritus is challenging because of the subjective symptoms and the multifactorial nature. Therefore, more studies are needed to determine the best strategy to assess itch intensity.
Authors: Jung Eun Kim; Min Kyung Shin; Gyeong-Hun Park; Un Ha Lee; Ji Hyun Lee; Tae-Young Han; Hyun Chang Koh; Yong Hyun Jang; Hye One Kim; Chan Ho Na; Bark-Lynn Lew; Ji Young Ahn; Chang Ook Park; Young Joon Seo; Yang Won Lee; Sang Wook Sohn; Young Lip Park Journal: Ann Dermatol Date: 2019-10-31 Impact factor: 1.444