Relying primarily on patient global assessments falls short in determining comprehensive disease severity, but by adding the Skindex instrument or other measures, clinicians may obtain a better evaluation of patient quality of life, according to a panel of stakeholders on behalf of the International Dermatology Outcome Measures and the American Academy of Dermatology.
In a review of patient-reported outcome measures, researchers evaluated seven different patient global assessments (PtGA): the PtGA used in a chronic hand eczema trial; a PtGA based on an 11-point numerical rating scale used for psoriatic arthritis; a 6-point PtGA based on the psoriasis investigator global assessment; and the patient’s global component of the Beer Sheva Psoriasis Score, the National Psoriasis Foundation-Psoriasis Score, the Simplified Psoriasis Index and the Urticaria Control Test.
Twenty-four individuals took part in the voting: two patients with psoriasis, two patients with psoriasis and psoriatic arthritis, 10 patients with atopic dermatitis, three caregivers for patients with atopic dermatitis and seven patients with acne. The voting focused on identifying the minimal set of assessment for clinical practice, patient global assessments, Skindex instruments and a final instrument selection for quality improvement.
The researchers aimed to achieve consensus on a patient-reported outcomes measure for clinical practice.
The adequacy of treatment response was voted as the most important minimal assessment for clinical practice among 56% of respondents.
Ninety-two percent of physicians voted that the feasibility of patient-reported outcome measures assessing quality of life is more important than its comprehensiveness vs. 55% of patients who voted for feasibility over comprehensiveness.
According to 72% of the respondents, patient-reported outcome measures are essential as a way to begin the conversation between the patient and clinician about the disease impact.
Using a Skindex instrument is more important than using a “trajectory measure” according to 74% of respondents, or a 5-point PtGA, according to 86%.
“[Patient-reported outcome measures] are increasingly being recognized for quality measurement and they can be used as structural, outcome and/or process measures. However, their use to assess individual provider performance presents certain limitations,” Lourdes Perez-Chada, MD, MMSc, of the department of dermatology at Brigham and Women’s Hospital, Harvard Medical School, and colleagues wrote.
The respondents reached consensus that PtGA is not adequate as a stand-alone measure to capture enough information into a patient’s disease impact but provides a more comprehensive measure of health-related quality of life in combination with Skindex instrument or other health-related quality of life measure, according to researchers. – by Abigail Sutton
Disclosures: Perez-Chada reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.