Atopic dermatitis and skin diseaseAssessment of clinical signs of atopic dermatitis: A systematic review and recommendation
Section snippets
Methods
We conducted a systematic review on the measurement properties of outcome measures for clinical signs of AD according to an a priori study protocol. The protocol of our review was registered in the international prospective register of systematic reviews (PROSPERO; registration no. CRD42013003935, http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42013003935).
Results
We identified 45 eligible articles.7, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63 Of these, 43 studies were identified by means of electronic search, and 2 studies47, 57 were identified through hand search. The flow diagram (Fig 1)64 provides information on study identification and the selection process. Table E2 in this article's Online Repository at //www.jacionline.org
Discussion
This systematic review identified, summarized, and critically appraised 16 different outcome measures to assess the severity of clinical signs of AD. Although none of these instruments completely met all the predefined criteria for adequate truth, discrimination, and feasibility, substantial validation work has been undertaken since our previous review.7
The EASI54 and SCORAD32 are the best instruments available to measure clinical signs of AD.
The SCORAD is a valid, internally consistent,
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This publication describes work conducted on behalf of the Harmonising Outcome Measures for Atopic Dermatitis (HOME) Initiative, which is supported through an independent research grant funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-0407-10177). The views expressed in this publication are those of the author or authors and not necessarily those of the National Health Service, the NIHR, or the Department of Health.
Disclosure of potential conflict of interest: S. Langan has received one or more grants from or has one or more grants pending with the National Institute for Health Research (NIHR; UK Department of Health). L. von Kobyletzki is a Board member for 100000DK, is employed by 1560000SEK, and has received one or more grants from or has one or more grants pending with 452500SEK. K. Thomas has been supported by an NIHR Programme Grant for Applied Research. The rest of the authors declare that they have no relevant conflicts of interest.
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These authors contributed equally to this work.