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Development and Initial Validation of a New Tool for Measuring Atopic Eczema Severity From the Patients’ Perspective

Carolyn R. Charman, BM, BCh, MRCP; Andrea J. Venn, PhD, MSc; Hywel C. Williams, PhD, FRCP

Arch Dermatol. 2004;140:1513-1519.

Objective  To develop a simple, valid, repeatable, and readily understandable patient-oriented assessment measure for monitoring disease activity in children and adults with atopic eczema.

Design  Qualitative semistructured patient interviews identified a list of symptoms of atopic eczema. These symptoms were quantitatively analyzed in a larger patient population to identify which symptoms were important to patients and amenable to monitoring as part of a scoring system.

Setting  The outpatient Department of Dermatology at the Queen’s Medical Centre, University Hospital, Nottingham, England, and 5 local general practices.

Patients  Four hundred thirty-five patients with atopic eczema.

Results  Seven symptoms were incorporated into the final patient-oriented eczema measure using a simple 5-point scale of frequency of occurrence during the previous week, with a maximum total score of 28. Validity testing against the Dermatology Life Quality Index, Children’s Dermatology Life Quality Index, and patients’ global severity assessments showed good correlation (r = 0.78, r = 0.73, and r = 0.81, respectively; P<.001). Internal consistency was high (Cronbach  = 0.88), and test-retest reliability was good, with 95% of scores falling within 2.6 points on repeat testing (mean score difference, 0.04; SD, 1.32). Individual variables in the measure demonstrated sensitivity to change during a 4-week in-clinic period and an 18-week randomized controlled clinical trial.

Conclusion  The patient-oriented eczema measure is a practical self-assessed measurement tool for monitoring aspects of atopic eczema that are important to patients in routine clinical practice or in the clinical trial setting.

Author Affiliations: Department of Dermatology, Queen’s Medical Centre (Drs Charman and Williams), and Department of Epidemiology and Public Health, University of Nottingham (Dr Venn), Nottingham, England.

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