What are the benefits of scoring atopic dermatitis in current practice?

  • 15min
  • Supported by
    • La Roche-Posay

Valid and clinically meaningful outcome measures play a central role in both the interpretation of clinical trial results and the ongoing assessment of healthcare intervention to ensure that research can be translated into maximum patient benefit.1

For measuring disease severity, 28 different scales exist, without a single gold standard emerging.2

They are used primarily in clinical trials and rarely in clinical practice as the systems were designed for an investigative setting and are often too time-consuming for routine use in outpatient clinics or for monitoring patient responses in general practice.1,2

  

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What should we approach the scores?





What should be done in current practice?





What should be done in future practice?


Patient-oriented medicine is an emerging concept encouraged by the World Health Organization which allows for greater patient involvement in the management of chronic diseases.

Periodic assessment by a doctor is useful to assess the efficacy of treatment at one given moment. However, AD is characterized by unpredictable flare-ups and remissions, causing clinical variations between two consultations. Therefore, periodic assessment cannot evaluate the disease course or treatment efficacy comprehensively.

Self-assessment, if reliable, could enable better monitoring of disease status. Moreover, self-assessment scores (SAS) can be an effective tool for communication between patients and physicians on everyday disease management issues and could be a valuable adjunct to a therapeutic education programme.6

Bibliography

  1. Charman C.R., Venn A.J., Williams H.C. The Patient-Oriented Eczema Measure Development and Initial Validation of a New Tool for Measuring Atopic Eczema Severity From the Patients’ Perspective. Arch Dermatol. 2004;140(12):1513–9.
  2. Eichenfield L.F., Tom W.L., Chamlin S.L. et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014 Feb;70(2):338–51.
  3. Consensus Report of the European Task Force on Atopic Dermatitis. Severity Score of Atopic Dermatitis: the SCORAD Index. Dermatology 1993;186:23–31.
  4. Oranje A.P., Glazenburg E.J., Wolkerstorfer A., de Waard-van der Spek F.B. Practical issues on interpretation of scoring atopic dermatitis: the SCORAD index, objective SCORAD and the three-item severity score. Br J Dermatol. 2007;157:645–8.
  5. Charman C.R., Venn A.J., Williams H.C. Reliability testing of the Six Area, Six Sign Atopic Dermatitis severity score. Br J Dermatol. 2002;146:1057–1060.
  6. Stalder J.-F., Barbarot S., Wollenberg A. et al, for the PO-SCORAD Investigators Group. Patient-Oriented SCORAD (PO-SCORAD): a new self-assessment scale in atopic dermatitis validated in Europe. Allergy 2011;88:1114–21.
  7. Wollenberg A., Oranje A., Deleuran M. et al. ETFAD/EADV Eczema task force 2015 position paper on diagnosis and treatment of atopic dermatitis in adult and paediatric patients. JEADV 2016;30:729–47.
  8. Akdis C.A., Akdis M.B., Bieber T. et al. Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report. J Allergy Clin Immunol 2006;118:152–69