PSY18 Validation of AAPPO Questionnaire in Adults and Adolescents with Alopecia Areata

Abstract

To establish the domain structure and scoring, and evaluate the psychometric properties of the Alopecia Areata Patient Priority Outcomes (AAPPO) questionnaire in adults and adolescents with Alopecia Areata (AA). Measurement properties of the AAPPO were examined using data from a prospective, non-interventional, web-based study of 121 AA patients (36 adolescents ages 12-17 years and 85 adults ages ≥18 years) with ≥25% hair loss, who completed two assessments (baseline and follow up 2 weeks later). Analyses provided here are inclusive of all patients (n=121). Exploratory and confirmatory factor analysis supported 6 domains: 4 individual Hair Loss (HL) items, Emotional Symptoms (ES, 4 items) and Activity Limitations (AL, 3 items). The multi-item ES and AL domains had strong internal consistency (Cronbach’s alpha≥0.87). All domain scores had strong test-retest reliability (ICC≥0.78). The four HL domain scores demonstrated strong construct validity (r≥0.52) when compared to the patient-reported Alopecia Areata Symptom and Impact Scale hair loss scale score. The ES and AL domain scores exhibited strong construct validity (ǀrǀ≥0.66) when compared to the patient-reported SF-36 Mental Component Summary score. Known groups analyses revealed that the HL mean domain scores were better (lower) in the clinician-reported Severity of Alopecia Tool (SALT) 25%-49% subgroup compared to those with highest SALT scores (76%-100%; p<0.0001). However, the ES mean domain scores were better for the SALT 76%-100% group in the same comparison (p<0.0001). These data demonstrate the reliability and validity of the AAPPO to measure symptom severity and impacts in adults and adolescents with AA.