Lourdes Perez-Chada1, Vanina L Taliercio2, Alice Gottlieb3, Marta Van Beek4, Kristina Callis Duffin2, Margo Reeder5, Joseph F Merola6, Robert A Swerlick7. 1. Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 2. Department of Dermatology, University of Utah, Salt Lake City, UT. 3. Department of Dermatology, Icahn School of Medicine at Mt Sinai, New York, NY. Electronic address: alice.gottlieb@mountsinai.org. 4. Department of Dermatology, University of Iowa, Iowa City, IA. 5. Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI. 6. Department of Dermatology and Department of Medicine, Division of Rheumatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. 7. Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, and Atlanta Veterans Administration Medical Center, Decatur, GA.
Abstract
BACKGROUND: The International Dermatology Outcome Measures and the American Academy of Dermatology recently agreed on a physician-reported global severity measure to demonstrate quality of care in inflammatory dermatoses. Because patient-reported outcome measures (PROMs) are also important, we aimed to achieve consensus on a PROM for clinical practice. METHODS: Patients and providers participated in a consensus-building study using a modified-Delphi technique. Voting focused on identifying: (i)minimal set of assessments for clinical practice; (ii)patient-global assessments (PtGAs); (iii)Skindex instruments; and (iv)final instrument selection for quality improvement. RESULTS: Among 53 stakeholders, >70% agreed that identification of patient goals, assessment of treatment harm and assessment of the adequacy of treatment response were the minimal assessments for clinical practice. The most preferred PtGA was a 5-point PtGA (0=clear to 4=severe) with an optional check-box: "worst ever". A new metric assessing change since treatment initiation called "trajectory measure" was proposed. Stakeholders preferred Skindex instruments over PtGAs and a trajectory measure for clinical practice. CONCLUSIONS: PtGAs as standalone measures do not adequately capture the patient's assessment of disease severity or impact of care. The combination of PtGAs with Skindex or other measure of health-related quality of life may provide a more comprehensive evaluation of patients in clinical practice.
BACKGROUND: The International Dermatology Outcome Measures and the American Academy of Dermatology recently agreed on a physician-reported global severity measure to demonstrate quality of care in inflammatory dermatoses. Because patient-reported outcome measures (PROMs) are also important, we aimed to achieve consensus on a PROM for clinical practice. METHODS:Patients and providers participated in a consensus-building study using a modified-Delphi technique. Voting focused on identifying: (i)minimal set of assessments for clinical practice; (ii)patient-global assessments (PtGAs); (iii)Skindex instruments; and (iv)final instrument selection for quality improvement. RESULTS: Among 53 stakeholders, >70% agreed that identification of patient goals, assessment of treatment harm and assessment of the adequacy of treatment response were the minimal assessments for clinical practice. The most preferred PtGA was a 5-point PtGA (0=clear to 4=severe) with an optional check-box: "worst ever". A new metric assessing change since treatment initiation called "trajectory measure" was proposed. Stakeholders preferred Skindex instruments over PtGAs and a trajectory measure for clinical practice. CONCLUSIONS: PtGAs as standalone measures do not adequately capture the patient's assessment of disease severity or impact of care. The combination of PtGAs with Skindex or other measure of health-related quality of life may provide a more comprehensive evaluation of patients in clinical practice.
Authors: Vanina L Taliercio; Ashley M Snyder; Allison M Biggs; Jacob Kean; Rachel Hess; Kristina Callis Duffin; Amy M Cizik; Aaron M Secrest Journal: Qual Life Res Date: 2021-11-02 Impact factor: 4.147
Authors: Alison H Kohn; Afsaneh Alavi; April W Armstrong; Folawiyo Babalola; Amit Garg; Alice B Gottlieb; Lesley Grilli; Gregor Borut Ernst Jemec; John Latella; Kendall Marcus; Joseph F Merola; Alex G Ortega-Loayza; Daniel M Siegel; Vibeke Strand; Jerry K L Tan; Lourdes M Perez-Chada Journal: Dermatology Date: 2021-09-17 Impact factor: 5.197
Authors: G B Langbroek; A Wolkerstorfer; S E R Horbach; P I Spuls; K M Kelly; S J Robertson; M I van Raath; F Al-Niaimi; T Kono; P Boixeda; H J Laubach; A M Badawi; A Troilius Rubin; M Haedersdal; W Manuskiatti; C M A M van der Horst; D T Ubbink Journal: J Eur Acad Dermatol Venereol Date: 2021-06-16 Impact factor: 6.166