Journal Reading - Alergi

7/30/2019 Journal Reading - Alergi

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Journal Reading of Allergyand Immunology Sub Dept

Patient-OrientedSCORAD (PO-

SCORAD): a new self-

assessment scale in

atopic dermatitis

validated in Europe

Stalder et al

Allergy 66(2011):1114-1121


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IntroductionChronic/relapsing

pruritic inflammatoryskin disease

Dry skin

Significant impactQOL

Public health cost

Industrialized CountriesChildren : 10 20%

Adults : 1 3%

ATOPICDERMATITIS


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Introduction

Severity +management

ETFAD (1992)

SCORAD

(efficacy tx)

CharacteristicAD is not

similar each

course

Assessmentby doctorinsufficient


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Introduction

SELFASSESSMENT

SCALE

Bettermonitoring

An effectivecommunication

tool

Require greaterpatients

involvement

SA-EASI ratingscale, Skin

Detective scale,ADQ, POEM

scale


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Introduction

Subjective

symptoms

Objectivesymptoms

PO-SCORAD

SAS by ETFAD

To validate this scale in a large European population of adults and children

To assess the consistency between SCORAD PO-SCORAD

To confirm PO-SCORAD is quick and easy


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Patients and MethodsProspective,

observationalstudy

Feb 09 Jan2010

Belgium,Denmark,

Finland, France,Germany, Italy,

the Netherlands,Sweden,

Switzerland

The protocol was

validated byindependentscientific (ETFAD)

Informed Consent


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Subjects and Procedures

Adults (> 18 yo) children (< 18 yo)

understand and complete thePO-SCORAD questionnaire

Disease severity : D0 and D28

Evaluation based on the same items, objective and subjective symptoms:1. Surface area of skin affected by eczema in the last 3 days2. Dryness of the skin without eczema3. Evaluation of the severity of the eczema over the last 3 days (redness of

skin affected by eczema, swelling, oozing/crust, scratching and thickening),

4. Pruritus and sleep loss


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Evaluation Criteria and plan ofAnalysis

Consistency between PO-SCORAD and SCORAD,

coefficient correlation > 0.7 with a lower limit of CI 95% >

0.65

Main criteria : correlation between PO-SCORAD and SCORADindexes at D0 for overall population

The consistency between 2 scales was evaluated :

Correlation between 2 scales indexes at D28 for all

populationD28, time period D0 D28 > 21 days and 21 days and < 35 days

The same correlations were also determined for adults

and children subgroups


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Statistical Analysis SAS software (9.13 ver, pack 4, SAS Institute Inc., Cary, NC,

USA)

Quantitative data : number of patients, missing data, meanand standard deviation, min-max.

Between group comparison : Students t-test/Wilcoxon ranksum test (nonparametric)

Qualitative data : available data, missing data, totalnumbers, percentage

Comparison adults-children : Chi-square test/exact Fishertest

Correlation PO-SCORAD SCORAD at D0 and D28 : Bravais-Pearson correlation coefficient


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Resuts


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Discussion

Validating the ability of PO-SCORAD to self-assess ADseverity

Confirming the results in pilot study in a large population(75% mild-moderate, 25% severe)

PO-SCORAD and SCORAD were well correlated

At D0 : correlation at D0 was good, lower than that assumedin design of the protocol

Post hoc analysis : both D0 and D28, the correlation betweenSCORAD and PO-SCORAD at D0 was higher [r=0.71 (95%CI:0.64;0.75), p


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Discussion 2nd evaluation: correlation coefficient 0.79

Learning by doing

High correlation between absolute changes

from baseline SCORAD and PO-SCORADPO-SCORAD assess AD accurately

A valuable tool for doctor gives good estimate

of AD severity


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Discussion Present study had correlation much stronger

>> previous study

Visual explanation

PO-SCORAD is easy and feasible

No significant difference between PO-SCORAD

and SCORAD according to age


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DiscussionPO-

SCORAD

Subjective +objective

Symptomspictures

POEMscale

Adequatelyvalidated

subjectiveoutcome

SA-EASI

Itscounterpartfor doctor

Difficult forpatient

ADQ

Poorassessment

tool

SkinDetective

Scale

Similarwith PO-SCORAD

Difficult forchildren

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Journal Reading - Alergi