Remote severity assessment in atopic dermatitis: Validity and reliability of the remote Eczema Area and Severity Index and Self-Administered Eczema Area and Severity Index

Aviël Ragamin; Renske Schappin; N. Tan Nguyen; Anouk E.M. Nouwen; Lisanne F. Hoekstra; Marie L.A. Schuttelaar; Suzanne G.M.A. Pasmans

doi:10.1016/j.jdin.2023.07.019

Remote severity assessment in atopic dermatitis: Validity and reliability of the remote Eczema Area and Severity Index and Self-Administered Eczema Area and Severity Index

Aviël Ragamin
, Renske Schappin
, N. Tan Nguyen
, Anouk E.M. Nouwen
, Lisanne F. Hoekstra
, Marie L.A. Schuttelaar
, Suzanne G.M.A. Pasmans^*

^*Corresponding author for this work

Public Health Research (PHR)

Research output: Contribution to journal › Article › Academic › peer-review

10 Citations (Scopus)

97 Downloads (Pure)

Abstract

BACKGROUND: Reliable assessment of atopic dermatitis (AD) severity is necessary for clinical practice and research. Valid and reliable remote assessment is essential to facilitate remote care and research.

OBJECTIVES: Assess the validity and reliability of the Eczema Area and Severity Index (EASI) based on images and patient-assessed severity based on the Self-Administered EASI (SA-EASI).

METHODS: Whole-body clinical images were taken during consultation from children with AD. After consultations, caregivers completed the SA-EASI and provided images from home. Four raters assessed all images twice using EASI.

RESULTS: A total of 1534 clinical images and 425 patient-provided images were collected from 87 and 32 children. Excellent (0.90) validity, good inter (0.77) and intrarater reliability (0.91), and standard error of measurement (4.31) was found for the EASI based on clinical images. Feasibility of patient-provided images showed limitations with missing images (43.8%) and quality issues (23.1%). However, good validity (0.86), inter (0.74) and intrarater reliability (0.94) were found when assessment was possible. Moderate correlation (0.60) between SA-EASI and EASI was found.

LIMITATIONS: Low portion patient-provided images.

CONCLUSION: AD severity assessment based on images strongly correlates with in-person AD assessment. Good measurement properties confirm the potential of remote assessment. Moderate correlation between SA-EASI and in-person EASI suggest limited value of self-assessment.

Original language	English
Pages (from-to)	184-191
Number of pages	8
Journal	JAAD international
Volume	13
DOIs	https://doi.org/10.1016/j.jdin.2023.07.019
Publication status	Published - Dec-2023

Keywords

atopic dermatitis
clinical outcome measure
Eczema Area and Severity Index
medical dermatology
telemedicine
validated pediatric dermatology

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Ragamin, A., Schappin, R., Tan Nguyen, N., Nouwen, A. E. M., Hoekstra, L. F., Schuttelaar, M. L. A., & Pasmans, S. G. M. A. (2023). Remote severity assessment in atopic dermatitis: Validity and reliability of the remote Eczema Area and Severity Index and Self-Administered Eczema Area and Severity Index. JAAD international, 13, 184-191. https://doi.org/10.1016/j.jdin.2023.07.019

@article{64a54437e53d401097d28ecb3b915ebd,

title = "Remote severity assessment in atopic dermatitis: Validity and reliability of the remote Eczema Area and Severity Index and Self-Administered Eczema Area and Severity Index",

abstract = "BACKGROUND: Reliable assessment of atopic dermatitis (AD) severity is necessary for clinical practice and research. Valid and reliable remote assessment is essential to facilitate remote care and research.OBJECTIVES: Assess the validity and reliability of the Eczema Area and Severity Index (EASI) based on images and patient-assessed severity based on the Self-Administered EASI (SA-EASI).METHODS: Whole-body clinical images were taken during consultation from children with AD. After consultations, caregivers completed the SA-EASI and provided images from home. Four raters assessed all images twice using EASI.RESULTS: A total of 1534 clinical images and 425 patient-provided images were collected from 87 and 32 children. Excellent (0.90) validity, good inter (0.77) and intrarater reliability (0.91), and standard error of measurement (4.31) was found for the EASI based on clinical images. Feasibility of patient-provided images showed limitations with missing images (43.8\%) and quality issues (23.1\%). However, good validity (0.86), inter (0.74) and intrarater reliability (0.94) were found when assessment was possible. Moderate correlation (0.60) between SA-EASI and EASI was found.LIMITATIONS: Low portion patient-provided images.CONCLUSION: AD severity assessment based on images strongly correlates with in-person AD assessment. Good measurement properties confirm the potential of remote assessment. Moderate correlation between SA-EASI and in-person EASI suggest limited value of self-assessment.",

keywords = "atopic dermatitis, clinical outcome measure, Eczema Area and Severity Index, medical dermatology, telemedicine, validated pediatric dermatology",

author = "Avi{\"e}l Ragamin and Renske Schappin and \{Tan Nguyen\}, N. and Nouwen, \{Anouk E.M.\} and Hoekstra, \{Lisanne F.\} and Schuttelaar, \{Marie L.A.\} and Pasmans, \{Suzanne G.M.A.\}",

note = "Publisher Copyright: {\textcopyright} 2023 American Academy of Dermatology, Inc.",

year = "2023",

month = dec,

doi = "10.1016/j.jdin.2023.07.019",

language = "English",

volume = "13",

pages = "184--191",

journal = "JAAD international",

issn = "2666-3287",

publisher = "Elsevier",

}

TY - JOUR

T1 - Remote severity assessment in atopic dermatitis

T2 - Validity and reliability of the remote Eczema Area and Severity Index and Self-Administered Eczema Area and Severity Index

AU - Ragamin, Aviël

AU - Schappin, Renske

AU - Tan Nguyen, N.

AU - Nouwen, Anouk E.M.

AU - Hoekstra, Lisanne F.

AU - Schuttelaar, Marie L.A.

AU - Pasmans, Suzanne G.M.A.

PY - 2023/12

Y1 - 2023/12

N2 - BACKGROUND: Reliable assessment of atopic dermatitis (AD) severity is necessary for clinical practice and research. Valid and reliable remote assessment is essential to facilitate remote care and research.OBJECTIVES: Assess the validity and reliability of the Eczema Area and Severity Index (EASI) based on images and patient-assessed severity based on the Self-Administered EASI (SA-EASI).METHODS: Whole-body clinical images were taken during consultation from children with AD. After consultations, caregivers completed the SA-EASI and provided images from home. Four raters assessed all images twice using EASI.RESULTS: A total of 1534 clinical images and 425 patient-provided images were collected from 87 and 32 children. Excellent (0.90) validity, good inter (0.77) and intrarater reliability (0.91), and standard error of measurement (4.31) was found for the EASI based on clinical images. Feasibility of patient-provided images showed limitations with missing images (43.8%) and quality issues (23.1%). However, good validity (0.86), inter (0.74) and intrarater reliability (0.94) were found when assessment was possible. Moderate correlation (0.60) between SA-EASI and EASI was found.LIMITATIONS: Low portion patient-provided images.CONCLUSION: AD severity assessment based on images strongly correlates with in-person AD assessment. Good measurement properties confirm the potential of remote assessment. Moderate correlation between SA-EASI and in-person EASI suggest limited value of self-assessment.

AB - BACKGROUND: Reliable assessment of atopic dermatitis (AD) severity is necessary for clinical practice and research. Valid and reliable remote assessment is essential to facilitate remote care and research.OBJECTIVES: Assess the validity and reliability of the Eczema Area and Severity Index (EASI) based on images and patient-assessed severity based on the Self-Administered EASI (SA-EASI).METHODS: Whole-body clinical images were taken during consultation from children with AD. After consultations, caregivers completed the SA-EASI and provided images from home. Four raters assessed all images twice using EASI.RESULTS: A total of 1534 clinical images and 425 patient-provided images were collected from 87 and 32 children. Excellent (0.90) validity, good inter (0.77) and intrarater reliability (0.91), and standard error of measurement (4.31) was found for the EASI based on clinical images. Feasibility of patient-provided images showed limitations with missing images (43.8%) and quality issues (23.1%). However, good validity (0.86), inter (0.74) and intrarater reliability (0.94) were found when assessment was possible. Moderate correlation (0.60) between SA-EASI and EASI was found.LIMITATIONS: Low portion patient-provided images.CONCLUSION: AD severity assessment based on images strongly correlates with in-person AD assessment. Good measurement properties confirm the potential of remote assessment. Moderate correlation between SA-EASI and in-person EASI suggest limited value of self-assessment.

KW - atopic dermatitis

KW - clinical outcome measure

KW - Eczema Area and Severity Index

KW - medical dermatology

KW - telemedicine

KW - validated pediatric dermatology

UR - https://www.scopus.com/pages/publications/85174834043

U2 - 10.1016/j.jdin.2023.07.019

DO - 10.1016/j.jdin.2023.07.019

M3 - Article

C2 - 38025299

SN - 2666-3287

VL - 13

SP - 184

EP - 191

JO - JAAD international

JF - JAAD international

ER -

Remote severity assessment in atopic dermatitis: Validity and reliability of the remote Eczema Area and Severity Index and Self-Administered Eczema Area and Severity Index

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