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A Systematic Literature Review

John de Korte, MA; Femke M. C. Mombers, MA; Mirjam A. G. Sprangers, PhD; Jan D. Bos, PhD

Arch Dermatol. 2002;138:1221-1227.

Objective  To critically appraise the suitability of current quality-of-life (QOL) questionnaires for psoriasis research.

Data Sources  Computerized searches of 5 bibliographic databases.

Questionnaire Selection  Predefined criteria were used to identify QOL questionnaires in dermatologic studies. Two investigators independently assessed and agreed on multidimensional generic, dermatology-specific, and psoriasis-specific QOL questionnaires for inclusion.

Data Extraction  Data were extracted on the internal structure, reliability, and validity of the included questionnaires.

Data Synthesis  Three generic, 3 dermatology-specific, and none of the psoriasis-specific questionnaires met the inclusion criteria: the Nottingham Health Profile (NHP), the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), the Sickness Impact Profile (SIP), the Dermatology Quality of Life Scales (DQOLS), the Dermatology-Specific Quality of Life Instrument (DSQL), and the Skindex-29. The generic NHP, SF-36 and SIP are well established, reliable, and valid. Although the data are not conclusive, the SF-36 was useful to assess effects of psoriasis on its component scales. The dermatology-specific DQOLS, DSQL, and Skindex-29 are relatively new and, therefore, less widely tested. Available psychometric data demonstrated the reliability and validity of all 3 dermatology-specific questionnaires. The Skindex-29 was also useful to assess change.

Conclusions  None of the identified psoriasis-specific questionnaires met the inclusion criteria. Data on the suitability of the included questionnaires for psoriasis research were relatively sparse. The included generic questionnaires allow comparisons with nondermatologic diseases but do not allow assessment of relevant dermatology-specific aspects and are not sensitive to subtle effects of psoriasis on QOL. On the basis of the psychometric data of the present review, we find the Skindex-29 to be the most valuable dermatology-specific questionnaire for psoriasis research. Combination of the Skindex-29 with the generic SF-36 combines the merits of both types of questionnaires and we therefore recommend this combination.

From the Departments of Dermatology (Mr de Korte, Ms Mombers, and Dr Bos) and Medical Psychology (Dr Sprangers), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

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