Validity and reliability of Patient-Reported Outcomes Measurement Information System Global Health scale in adults with atopic dermatitis - 19/03/21

Doi : 10.1016/j.jaad.2021.01.033

Gabrielle Schwartzman, BS ^a, Donald Lei, MS ^b, Muhammad Yousaf, BS ^b, Sherief R. Janmohamed, MD, PhD ^b, Paras P. Vakharia, MD, PharmD ^c, Rishi Chopra, MD, MS ^d, Rajeev Chavda, MD ^e, Sylvie Gabriel, MD ^e, Kevin R. Patel, MD ^f, Vivek Singam, MD ^g, Robert Kantor, MD ^d, Derek Y. Hsu, MD ^h, Jonathan I. Silverberg, MD, PhD, MPH ^a,^b,^⁎
^a Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
^b Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, Illinois
^c Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
^d State University of New York Downstate Medical Center, Brooklyn, New York
^e Galderma SA, Rx Strategy and Innovation Group, La Tour-de-Peliz, Switzerland
^f Department of Dermatology, Dell Medical School, University of Texas, Austin, Texas
^g Department of Internal Medicine, Weiss Memorial Hospital, Chicago, Illinois
^h Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois

^∗Correspondence to: Jonathan I. Silverberg, MD, PhD, MPH, The George Washington University School of Medicine and Health Sciences, Department of Dermatology, Ste 2B-425, 2150 Pennsylvania Ave NW, Washington, DC 20037.The George Washington University School of Medicine and Health SciencesDepartment of DermatologySte 2B-4252150 Pennsylvania Ave NWWashingtonDC20037

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Abstract

Background

Patient-Reported Outcomes Measurement Information System Global Health (PGH) was validated to assess health-related quality of life in several diseases. Little is known about its measurement properties in adult atopic dermatitis.

Objective

Examine the measurement properties of PGH in adult atopic dermatitis.

Methods

A prospective dermatology practice–based study of 994 atopic dermatitis patients (18-97 years).

Results

PGH physical and mental health 4-item and abridged 2-item T scores, as well as mapped EuroQol-5D score, showed strong to very strong correlation with one another and moderate to strong Spearman correlations with Patient-Oriented Scoring Atopic Dermatitis, Patient-Health Questionnaire–9, Patient-Reported Outcomes Measurement Information System sleep disturbance and related impairment, Eczema Area and Severity Index, objective Scoring Atopic Dermatitis; and weak to moderate correlations with Patient Oriented Eczema Measure, numeric rating scale worst itch and average itch, and Scoring Atopic Dermatitis. The Dermatology Life Quality Index (DLQI) had stronger correlations with Patient Oriented Eczema Measure, Patient-Oriented Scoring Atopic Dermatitis, numeric rating scale worst itch and average itch, Eczema Area and Severity Index, and Scoring Atopic Dermatitis, but weaker correlations with Patient-Health Questionnaire–9 and Patient-Reported Outcomes Measurement Information System sleep disturbance and related impairment (convergent/divergent validity). PGH and DLQI scores had similarly poor ability to differentiate between levels of self-reported global atopic dermatitis severity (known-groups validity). No floor or ceiling effects were observed. No PGH or DLQI items had differential item functioning by demographics. PGH and DLQI scores showed fair to good responsiveness. Finally, PGH and DLQI showed similarly good test-retest reliability.

Limitations

Single-center study.

Conclusion

PGH scores had sufficient validity and reliability to assess health-related quality of life in atopic dermatitis.

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Key words : atopic dermatitis, eczema, itch, patient-reported outcomes, pruritus, severity

Abbreviations used : CI, DLQI, EASI, mEQ-5D, NRS, PGH, PGH-M2, PGH-M4, PGH-P2, PGH-P4, PHQ-9, POEM, PO-SCORAD, PROMIS, SCORAD

Plan

Patient characteristics

Concurrent validity

Convergent and divergent validity

Known-groups validity

Floor or ceiling effects

Differential item functioning

Responsiveness

Reliability

Discussion

	Funding sources: Supported by the Agency for Healthcare Research and Quality (grant K12 HS023011), the Dermatology Foundation, and a research grant from Galderma.
	IRB approval status: The study received approval by the institutional review boards of Northwestern University Feinberg School of Medicine.
	Reprints not available from the authors.