The Comparison between Objective and Subjective Severity Scores of Atopic Dermatitis

Abstract

RationaleMethods of measuring extent and severity of atopic dermatitis (AD) are based on assessment of signs and symptoms. Many scoring systems were validated, but they might not represent subjective severity of patients. The purpose of this study is to compare the subjective with the objective severity of scoring systems.MethodsFifty children (26 males, 24 females, aged between 3 months and 12 years) with AD were recruited by the pediatric allergy center at Soonchunhyang university hospital from June 1, 2007 to July 31, 2007. We checked their SCORAD (SCORing Atopic Dermatitis) score, EASI (Eczema Area and Severity Index) score, SASSAD (Six Area, Six Sign Atopic Dermatitis) score, Parental visual analog scale (PaVAS, 0-10 point), and Investigator's VAS (INVAS,0-10 point). We analyzed and compared each score with scales.ResultsSCORAD score had a strong correlation with EASI and SASSAD score (r = 0.84 vs 0.92). EASI score showed significant correlation with SASSAD score (r = 0.86). PaVAS was found to be less correlated with SCORAD, EASI and SASSAD scores (r = 0.37, 0.23, 0.33), whereas INVAS showed greater correlations with SCORAD, EASI and SASSAD score (r = 0.6, 0.52, 0.52). It demonstrated that established severity scoring systems has a greater correlation with severity by investigator's view-point but less correlation with subjective severity by patients'.ConclusionsEstablished scoring system or indices are generally reflect the objective severity by investigators. Therefore physicians should consider the patients' subjective severity when they take care of atopic dermatitis. RationaleMethods of measuring extent and severity of atopic dermatitis (AD) are based on assessment of signs and symptoms. Many scoring systems were validated, but they might not represent subjective severity of patients. The purpose of this study is to compare the subjective with the objective severity of scoring systems. Methods of measuring extent and severity of atopic dermatitis (AD) are based on assessment of signs and symptoms. Many scoring systems were validated, but they might not represent subjective severity of patients. The purpose of this study is to compare the subjective with the objective severity of scoring systems. MethodsFifty children (26 males, 24 females, aged between 3 months and 12 years) with AD were recruited by the pediatric allergy center at Soonchunhyang university hospital from June 1, 2007 to July 31, 2007. We checked their SCORAD (SCORing Atopic Dermatitis) score, EASI (Eczema Area and Severity Index) score, SASSAD (Six Area, Six Sign Atopic Dermatitis) score, Parental visual analog scale (PaVAS, 0-10 point), and Investigator's VAS (INVAS,0-10 point). We analyzed and compared each score with scales. Fifty children (26 males, 24 females, aged between 3 months and 12 years) with AD were recruited by the pediatric allergy center at Soonchunhyang university hospital from June 1, 2007 to July 31, 2007. We checked their SCORAD (SCORing Atopic Dermatitis) score, EASI (Eczema Area and Severity Index) score, SASSAD (Six Area, Six Sign Atopic Dermatitis) score, Parental visual analog scale (PaVAS, 0-10 point), and Investigator's VAS (INVAS,0-10 point). We analyzed and compared each score with scales. ResultsSCORAD score had a strong correlation with EASI and SASSAD score (r = 0.84 vs 0.92). EASI score showed significant correlation with SASSAD score (r = 0.86). PaVAS was found to be less correlated with SCORAD, EASI and SASSAD scores (r = 0.37, 0.23, 0.33), whereas INVAS showed greater correlations with SCORAD, EASI and SASSAD score (r = 0.6, 0.52, 0.52). It demonstrated that established severity scoring systems has a greater correlation with severity by investigator's view-point but less correlation with subjective severity by patients'. SCORAD score had a strong correlation with EASI and SASSAD score (r = 0.84 vs 0.92). EASI score showed significant correlation with SASSAD score (r = 0.86). PaVAS was found to be less correlated with SCORAD, EASI and SASSAD scores (r = 0.37, 0.23, 0.33), whereas INVAS showed greater correlations with SCORAD, EASI and SASSAD score (r = 0.6, 0.52, 0.52). It demonstrated that established severity scoring systems has a greater correlation with severity by investigator's view-point but less correlation with subjective severity by patients'. ConclusionsEstablished scoring system or indices are generally reflect the objective severity by investigators. Therefore physicians should consider the patients' subjective severity when they take care of atopic dermatitis. Established scoring system or indices are generally reflect the objective severity by investigators. Therefore physicians should consider the patients' subjective severity when they take care of atopic dermatitis.