545 Utility of PROMIS Itch in dermatology

Abstract

PROMIS (Patient-reported Outcome Measures Information System) is used to track domain-specific outcomes across all diseases and healthcare. This study examined the utility and validity of the new PROMIS Itch compared to the ItchyQoL during routine care in Dermatology at University of Rochester Medical Center. A health assessment, consisting of four PROMIS Itch short forms (General Itch, Itch Activity, Mood/Sleep and Scratching Behavior), ItchyQoL, Itch Numerical Rating Scale (NRS), PROMIS Pain Interference, and PROMIS Anxiety, was administered via iPads. PROMIS scores >55 were considered clinically significant. Severe itch scores were ≥3.68 (ItchyQoL) and 7-10 (NRS). All statistical analyses (Cronbach’s α, intraclass correlation (ICC), bivariate regression) were performed using JMPPro14. A total of 168 patients completed all PROMIS Itch short forms, ItchyQoL, and NRS. Overall itch scores were skewed toward mild itch (PROMIS Itch <33 = 39.3%; ItchyQoL <1.5 = 38.1%; NRS ≤1 = 36.9%). PROMIS Itch scores, especially Mood/Sleep and Scratching Behavior, correlated with ItchyQoL scores (r≥0.896). The internal consistency and reliability of PROMIS Itch were comparable to ItchyQoL (Cronbach’s α=0.938 and 0.943; ICC=0.936 and 0.938). However, PROMIS Itch showed high specificity for identifying patients with severe or uncontrolled itch related to their skin condition. Out of 20 patients with severe itch by ItchyQoL, PROMIS Itch recognized 18 patients with clinically significant itch and missed the two patients who had resolved/controlled itch. Additionally, the Scratching Behavior short form alone had similar specificity and higher sensitivity for severe itch than all PROMIS Itch forms together. We conclude that PROMIS Itch is a valid, reliable measure with minimal patient burden that identifies patients with severe or poorly controlled itch. Utilization of PROMIS Itch, along with other PROMIS domains, in routine dermatologic care may improve monitoring of itch burden and overall patient health.