The patient-oriented eczema measure - Development and initial validation of a new tool for measuring atopic eczema severity from the patients' perspective

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 alpha=0.88), and test-retest reliability was good, with 95% of scores failing 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.