Content and construct validity, predictors, and distribution of self-reported atopic dermatitis severity in US adults

Jonathan I. Silverberg, Zelma C. Chiesa Fuxench, Joel M. Gelfand, David J. Margolis, Mark Boguniewicz, Luz Fonacier, Mitchell H. Grayson, Eric Simpson, Peck Y. Ong

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Atopic dermatitis (AD) is associated with skin lesions, multiple symptoms, and effect of quality of life, all of which factor into disease severity. Self-reported global AD severity may be a valid severity assessment for epidemiologic research. Objective: To validate self-reported global AD severity in a representative cohort of adults with AD. Methods: Preliminary probing-cognitive interviews were performed (n = 8). Next, a cross-sectional US population-based survey study of adults with AD was performed. AD was diagnosed using an adap/tation of the UK Working Party criteria (n = 602). AD severity was assessed using self-reported global AD severity (mild, moderate, severe), Patient-Oriented Scoring AD (PO-SCORAD), Patient-Oriented Eczema Measure (POEM), Numeric Rating Scale (NRS)–itch, NRS-sleep, NRS-pain, and Hospital Anxiety and Depression Scale (HADS). Results: Self-reported global AD severity had good content validity. Self-reported global AD severity had strong correlations with PO-SCORAD (Spearman correlation ρ = 0.61) and objective PO-SCORAD (ρ = 0.61); moderate correlations with POEM (ρ = 0.54), NRS-itch (ρ = 0.44), NRS-pain (ρ = 0.46), and HADS (ρ = 0.41); and weak correlation with NRS-sleep (ρ =.32) (P <.001 for all). Consistent and significant correlations were observed in stratified analyses by age, sex, race/ethnicity, and level of education. There were stepwise increases of PO-SCORAD, NRS-itch, NRS-sleep, NRS-pain, POEM, and HADS with increasing self-reported global AD severity (Kruskal-Wallis test, P <.01). There was weak-moderate concordance between self-reported AD severity and established severity strata for PO-SCORAD (ρ = 0.44), NRS-itch (ρ = 0.30), and POEM (ρ = 0.43). Rather, self-reported global AD severity was best predicted by a combination of PO-SCORAD, POEM, NRS-itch, NRS-pain, and HADS. No differential item reporting was found by age, sex, or race/ethnicity. Conclusion: Self-reported AD severity simultaneously assesses multiple AD constructs and appears to be sufficiently valid for assessing AD severity in clinical and epidemiologic studies.

Original languageEnglish (US)
JournalAnnals of Allergy, Asthma and Immunology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Atopic Dermatitis
Eczema
Anxiety
Depression
Pain
Sleep

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

Cite this

Silverberg, J. I., Chiesa Fuxench, Z. C., Gelfand, J. M., Margolis, D. J., Boguniewicz, M., Fonacier, L., ... Ong, P. Y. (Accepted/In press). Content and construct validity, predictors, and distribution of self-reported atopic dermatitis severity in US adults. Annals of Allergy, Asthma and Immunology. https://doi.org/10.1016/j.anai.2018.07.040

Content and construct validity, predictors, and distribution of self-reported atopic dermatitis severity in US adults. / Silverberg, Jonathan I.; Chiesa Fuxench, Zelma C.; Gelfand, Joel M.; Margolis, David J.; Boguniewicz, Mark; Fonacier, Luz; Grayson, Mitchell H.; Simpson, Eric; Ong, Peck Y.

In: Annals of Allergy, Asthma and Immunology, 01.01.2018.

Research output: Contribution to journalArticle

Silverberg, Jonathan I. ; Chiesa Fuxench, Zelma C. ; Gelfand, Joel M. ; Margolis, David J. ; Boguniewicz, Mark ; Fonacier, Luz ; Grayson, Mitchell H. ; Simpson, Eric ; Ong, Peck Y. / Content and construct validity, predictors, and distribution of self-reported atopic dermatitis severity in US adults. In: Annals of Allergy, Asthma and Immunology. 2018.
@article{c069e874ae5948d5ba401d0fec466905,
title = "Content and construct validity, predictors, and distribution of self-reported atopic dermatitis severity in US adults",
abstract = "Background: Atopic dermatitis (AD) is associated with skin lesions, multiple symptoms, and effect of quality of life, all of which factor into disease severity. Self-reported global AD severity may be a valid severity assessment for epidemiologic research. Objective: To validate self-reported global AD severity in a representative cohort of adults with AD. Methods: Preliminary probing-cognitive interviews were performed (n = 8). Next, a cross-sectional US population-based survey study of adults with AD was performed. AD was diagnosed using an adap/tation of the UK Working Party criteria (n = 602). AD severity was assessed using self-reported global AD severity (mild, moderate, severe), Patient-Oriented Scoring AD (PO-SCORAD), Patient-Oriented Eczema Measure (POEM), Numeric Rating Scale (NRS)–itch, NRS-sleep, NRS-pain, and Hospital Anxiety and Depression Scale (HADS). Results: Self-reported global AD severity had good content validity. Self-reported global AD severity had strong correlations with PO-SCORAD (Spearman correlation ρ = 0.61) and objective PO-SCORAD (ρ = 0.61); moderate correlations with POEM (ρ = 0.54), NRS-itch (ρ = 0.44), NRS-pain (ρ = 0.46), and HADS (ρ = 0.41); and weak correlation with NRS-sleep (ρ =.32) (P <.001 for all). Consistent and significant correlations were observed in stratified analyses by age, sex, race/ethnicity, and level of education. There were stepwise increases of PO-SCORAD, NRS-itch, NRS-sleep, NRS-pain, POEM, and HADS with increasing self-reported global AD severity (Kruskal-Wallis test, P <.01). There was weak-moderate concordance between self-reported AD severity and established severity strata for PO-SCORAD (ρ = 0.44), NRS-itch (ρ = 0.30), and POEM (ρ = 0.43). Rather, self-reported global AD severity was best predicted by a combination of PO-SCORAD, POEM, NRS-itch, NRS-pain, and HADS. No differential item reporting was found by age, sex, or race/ethnicity. Conclusion: Self-reported AD severity simultaneously assesses multiple AD constructs and appears to be sufficiently valid for assessing AD severity in clinical and epidemiologic studies.",
author = "Silverberg, {Jonathan I.} and {Chiesa Fuxench}, {Zelma C.} and Gelfand, {Joel M.} and Margolis, {David J.} and Mark Boguniewicz and Luz Fonacier and Grayson, {Mitchell H.} and Eric Simpson and Ong, {Peck Y.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.anai.2018.07.040",
language = "English (US)",
journal = "Annals of Allergy, Asthma and Immunology",
issn = "1081-1206",
publisher = "American College of Allergy, Asthma and Immunology",

}

TY - JOUR

T1 - Content and construct validity, predictors, and distribution of self-reported atopic dermatitis severity in US adults

AU - Silverberg, Jonathan I.

AU - Chiesa Fuxench, Zelma C.

AU - Gelfand, Joel M.

AU - Margolis, David J.

AU - Boguniewicz, Mark

AU - Fonacier, Luz

AU - Grayson, Mitchell H.

AU - Simpson, Eric

AU - Ong, Peck Y.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Atopic dermatitis (AD) is associated with skin lesions, multiple symptoms, and effect of quality of life, all of which factor into disease severity. Self-reported global AD severity may be a valid severity assessment for epidemiologic research. Objective: To validate self-reported global AD severity in a representative cohort of adults with AD. Methods: Preliminary probing-cognitive interviews were performed (n = 8). Next, a cross-sectional US population-based survey study of adults with AD was performed. AD was diagnosed using an adap/tation of the UK Working Party criteria (n = 602). AD severity was assessed using self-reported global AD severity (mild, moderate, severe), Patient-Oriented Scoring AD (PO-SCORAD), Patient-Oriented Eczema Measure (POEM), Numeric Rating Scale (NRS)–itch, NRS-sleep, NRS-pain, and Hospital Anxiety and Depression Scale (HADS). Results: Self-reported global AD severity had good content validity. Self-reported global AD severity had strong correlations with PO-SCORAD (Spearman correlation ρ = 0.61) and objective PO-SCORAD (ρ = 0.61); moderate correlations with POEM (ρ = 0.54), NRS-itch (ρ = 0.44), NRS-pain (ρ = 0.46), and HADS (ρ = 0.41); and weak correlation with NRS-sleep (ρ =.32) (P <.001 for all). Consistent and significant correlations were observed in stratified analyses by age, sex, race/ethnicity, and level of education. There were stepwise increases of PO-SCORAD, NRS-itch, NRS-sleep, NRS-pain, POEM, and HADS with increasing self-reported global AD severity (Kruskal-Wallis test, P <.01). There was weak-moderate concordance between self-reported AD severity and established severity strata for PO-SCORAD (ρ = 0.44), NRS-itch (ρ = 0.30), and POEM (ρ = 0.43). Rather, self-reported global AD severity was best predicted by a combination of PO-SCORAD, POEM, NRS-itch, NRS-pain, and HADS. No differential item reporting was found by age, sex, or race/ethnicity. Conclusion: Self-reported AD severity simultaneously assesses multiple AD constructs and appears to be sufficiently valid for assessing AD severity in clinical and epidemiologic studies.

AB - Background: Atopic dermatitis (AD) is associated with skin lesions, multiple symptoms, and effect of quality of life, all of which factor into disease severity. Self-reported global AD severity may be a valid severity assessment for epidemiologic research. Objective: To validate self-reported global AD severity in a representative cohort of adults with AD. Methods: Preliminary probing-cognitive interviews were performed (n = 8). Next, a cross-sectional US population-based survey study of adults with AD was performed. AD was diagnosed using an adap/tation of the UK Working Party criteria (n = 602). AD severity was assessed using self-reported global AD severity (mild, moderate, severe), Patient-Oriented Scoring AD (PO-SCORAD), Patient-Oriented Eczema Measure (POEM), Numeric Rating Scale (NRS)–itch, NRS-sleep, NRS-pain, and Hospital Anxiety and Depression Scale (HADS). Results: Self-reported global AD severity had good content validity. Self-reported global AD severity had strong correlations with PO-SCORAD (Spearman correlation ρ = 0.61) and objective PO-SCORAD (ρ = 0.61); moderate correlations with POEM (ρ = 0.54), NRS-itch (ρ = 0.44), NRS-pain (ρ = 0.46), and HADS (ρ = 0.41); and weak correlation with NRS-sleep (ρ =.32) (P <.001 for all). Consistent and significant correlations were observed in stratified analyses by age, sex, race/ethnicity, and level of education. There were stepwise increases of PO-SCORAD, NRS-itch, NRS-sleep, NRS-pain, POEM, and HADS with increasing self-reported global AD severity (Kruskal-Wallis test, P <.01). There was weak-moderate concordance between self-reported AD severity and established severity strata for PO-SCORAD (ρ = 0.44), NRS-itch (ρ = 0.30), and POEM (ρ = 0.43). Rather, self-reported global AD severity was best predicted by a combination of PO-SCORAD, POEM, NRS-itch, NRS-pain, and HADS. No differential item reporting was found by age, sex, or race/ethnicity. Conclusion: Self-reported AD severity simultaneously assesses multiple AD constructs and appears to be sufficiently valid for assessing AD severity in clinical and epidemiologic studies.

UR - http://www.scopus.com/inward/record.url?scp=85054855947&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054855947&partnerID=8YFLogxK

U2 - 10.1016/j.anai.2018.07.040

DO - 10.1016/j.anai.2018.07.040

M3 - Article

JO - Annals of Allergy, Asthma and Immunology

JF - Annals of Allergy, Asthma and Immunology

SN - 1081-1206

ER -