Severity strata for POEM, PO-SCORAD, and DLQI in US adults with atopic dermatitis

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

Research output: Contribution to journalArticle

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Abstract

Background: Patient-Oriented Eczema Measure (POEM) is the preferred patient-reported outcome (PRO) for assessing symptoms of atopic dermatitis (AD). Dermatology Life Quality Index (DLQI) is commonly used to assess the burden of skin disease. Previous severity strata were developed for POEM and DLQI in clinical cohorts, which may be biased toward more severe disease. Severity strata were not previously examined in population-based cohorts. Patient-Oriented Scoring AD (PO-SCORAD) is another commonly used PRO for assessing AD symptoms; however, severity strata are not established. Objective: We sought to confirm previously developed strata for POEM and DLQI, and to develop strata for the PO-SCORAD in a population-based cohort of adults with AD. Methods: A cross-sectional, population-based study of 8,217 adults was performed using a structured questionnaire. A diagnosis of AD was determined using modified UK Diagnostic Criteria for AD (n = 602). AD severity was assessed using self-reported global AD severity (anchoring question), POEM, PO-SCORAD, and DLQI. Strata were selected using an anchoring approach based on patient-reported disease severity. Results: We confirmed the existing strata for DLQI (mild = 0-5, moderate = 6-10, severe = 11-30) (kappa = 0.446). However, the preferred strata for POEM was mild = 0-7, moderate = 8-19, and severe = 20-28 (kappa = 0.409) and PO-SCORAD was mild = 1-27, moderate = 28-56, severe = 57-104 (kappa = 0.444). Conclusion: Existing strata for DLQI performed well in a population-based cohort of adult AD. The optimal severity strata for the POEM in our AD population varies slightly from those previously published for AD. This may suggest that different strata may be optimal in different study settings and cohorts. Finally, we proposed new strata for PO-SCORAD in adult AD.

Original languageEnglish (US)
Pages (from-to)464-471
Number of pages8
JournalAnnals of Allergy, Asthma and Immunology
Volume121
Issue number4
DOIs
StatePublished - Oct 1 2018

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Eczema
Atopic Dermatitis
Dermatology
Quality of Life
Population
Skin Diseases
Cohort Studies

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

Cite this

Silverberg, J. I., Gelfand, J. M., Margolis, D. J., Fonacier, L., Boguniewicz, M., Schwartz, L. B., ... Fuxench, Z. C. C. (2018). Severity strata for POEM, PO-SCORAD, and DLQI in US adults with atopic dermatitis. Annals of Allergy, Asthma and Immunology, 121(4), 464-471. https://doi.org/10.1016/j.anai.2018.07.004

Severity strata for POEM, PO-SCORAD, and DLQI in US adults with atopic dermatitis. / Silverberg, Jonathan I.; Gelfand, Joel M.; Margolis, David J.; Fonacier, Luz; Boguniewicz, Mark; Schwartz, Lawrence B.; Simpson, Eric; Grayson, Mitchell H.; Ong, Peck Y.; Fuxench, Zelma C.Chiesa.

In: Annals of Allergy, Asthma and Immunology, Vol. 121, No. 4, 01.10.2018, p. 464-471.

Research output: Contribution to journalArticle

Silverberg, JI, Gelfand, JM, Margolis, DJ, Fonacier, L, Boguniewicz, M, Schwartz, LB, Simpson, E, Grayson, MH, Ong, PY & Fuxench, ZCC 2018, 'Severity strata for POEM, PO-SCORAD, and DLQI in US adults with atopic dermatitis', Annals of Allergy, Asthma and Immunology, vol. 121, no. 4, pp. 464-471. https://doi.org/10.1016/j.anai.2018.07.004
Silverberg JI, Gelfand JM, Margolis DJ, Fonacier L, Boguniewicz M, Schwartz LB et al. Severity strata for POEM, PO-SCORAD, and DLQI in US adults with atopic dermatitis. Annals of Allergy, Asthma and Immunology. 2018 Oct 1;121(4):464-471. https://doi.org/10.1016/j.anai.2018.07.004
Silverberg, Jonathan I. ; Gelfand, Joel M. ; Margolis, David J. ; Fonacier, Luz ; Boguniewicz, Mark ; Schwartz, Lawrence B. ; Simpson, Eric ; Grayson, Mitchell H. ; Ong, Peck Y. ; Fuxench, Zelma C.Chiesa. / Severity strata for POEM, PO-SCORAD, and DLQI in US adults with atopic dermatitis. In: Annals of Allergy, Asthma and Immunology. 2018 ; Vol. 121, No. 4. pp. 464-471.
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abstract = "Background: Patient-Oriented Eczema Measure (POEM) is the preferred patient-reported outcome (PRO) for assessing symptoms of atopic dermatitis (AD). Dermatology Life Quality Index (DLQI) is commonly used to assess the burden of skin disease. Previous severity strata were developed for POEM and DLQI in clinical cohorts, which may be biased toward more severe disease. Severity strata were not previously examined in population-based cohorts. Patient-Oriented Scoring AD (PO-SCORAD) is another commonly used PRO for assessing AD symptoms; however, severity strata are not established. Objective: We sought to confirm previously developed strata for POEM and DLQI, and to develop strata for the PO-SCORAD in a population-based cohort of adults with AD. Methods: A cross-sectional, population-based study of 8,217 adults was performed using a structured questionnaire. A diagnosis of AD was determined using modified UK Diagnostic Criteria for AD (n = 602). AD severity was assessed using self-reported global AD severity (anchoring question), POEM, PO-SCORAD, and DLQI. Strata were selected using an anchoring approach based on patient-reported disease severity. Results: We confirmed the existing strata for DLQI (mild = 0-5, moderate = 6-10, severe = 11-30) (kappa = 0.446). However, the preferred strata for POEM was mild = 0-7, moderate = 8-19, and severe = 20-28 (kappa = 0.409) and PO-SCORAD was mild = 1-27, moderate = 28-56, severe = 57-104 (kappa = 0.444). Conclusion: Existing strata for DLQI performed well in a population-based cohort of adult AD. The optimal severity strata for the POEM in our AD population varies slightly from those previously published for AD. This may suggest that different strata may be optimal in different study settings and cohorts. Finally, we proposed new strata for PO-SCORAD in adult AD.",
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T1 - Severity strata for POEM, PO-SCORAD, and DLQI in US adults with atopic dermatitis

AU - Silverberg, Jonathan I.

AU - Gelfand, Joel M.

AU - Margolis, David J.

AU - Fonacier, Luz

AU - Boguniewicz, Mark

AU - Schwartz, Lawrence B.

AU - Simpson, Eric

AU - Grayson, Mitchell H.

AU - Ong, Peck Y.

AU - Fuxench, Zelma C.Chiesa

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N2 - Background: Patient-Oriented Eczema Measure (POEM) is the preferred patient-reported outcome (PRO) for assessing symptoms of atopic dermatitis (AD). Dermatology Life Quality Index (DLQI) is commonly used to assess the burden of skin disease. Previous severity strata were developed for POEM and DLQI in clinical cohorts, which may be biased toward more severe disease. Severity strata were not previously examined in population-based cohorts. Patient-Oriented Scoring AD (PO-SCORAD) is another commonly used PRO for assessing AD symptoms; however, severity strata are not established. Objective: We sought to confirm previously developed strata for POEM and DLQI, and to develop strata for the PO-SCORAD in a population-based cohort of adults with AD. Methods: A cross-sectional, population-based study of 8,217 adults was performed using a structured questionnaire. A diagnosis of AD was determined using modified UK Diagnostic Criteria for AD (n = 602). AD severity was assessed using self-reported global AD severity (anchoring question), POEM, PO-SCORAD, and DLQI. Strata were selected using an anchoring approach based on patient-reported disease severity. Results: We confirmed the existing strata for DLQI (mild = 0-5, moderate = 6-10, severe = 11-30) (kappa = 0.446). However, the preferred strata for POEM was mild = 0-7, moderate = 8-19, and severe = 20-28 (kappa = 0.409) and PO-SCORAD was mild = 1-27, moderate = 28-56, severe = 57-104 (kappa = 0.444). Conclusion: Existing strata for DLQI performed well in a population-based cohort of adult AD. The optimal severity strata for the POEM in our AD population varies slightly from those previously published for AD. This may suggest that different strata may be optimal in different study settings and cohorts. Finally, we proposed new strata for PO-SCORAD in adult AD.

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