Validation of remote atopic dermatitis severity assessment with the Eczema Area and Severity Ondex in children using caregiver-provided photos and videos.


Journal

Pediatric dermatology
ISSN: 1525-1470
Titre abrégé: Pediatr Dermatol
Pays: United States
ID NLM: 8406799

Informations de publication

Date de publication:
Jul 2022
Historique:
revised: 19 02 2022
received: 25 11 2021
accepted: 27 03 2022
pubmed: 7 5 2022
medline: 27 8 2022
entrez: 6 5 2022
Statut: ppublish

Résumé

We sought to quantify the reliability and validity of remote atopic dermatitis (AD) severity assessment using the Eczema Area and Severity Index (EASI) applied to caregiver-provided photos (p-EASI) and videos (v-EASI). Children (0-17 years) with a physician diagnosis of AD were recruited. Caregivers took photos and a video of their child's skin. A clinician scored in-person EASI on the same day, then p-EASI and v-EASI for each participant 10 days or more between ratings. Two additional clinicians scored p-EASI and v-EASI. Lin's concordance correlation coefficient (CCC) was employed to assess criterion validity using in-person EASI as the gold standard. Intraclass correlation coefficients (ICCs) were calculated to assess interrater reliability of p-EASI and v-EASI. Fifty racially and ethnically diverse children (age [mean ± SD]: 4.3 ± 4.4 years; 42% female) with a range of AD severity (EASI: 6.3 ± 6.4) and Fitzpatrick skin types (1-2: 9%; 3-4: 60%; 5-6: 31%) were enrolled and received in-person EASI assessment. Fifty had p-EASI and 49 had v-EASI by the same in-person rater, and by two additional raters. The CCC and ICC for p-EASI were 0.89, 95% CI [0.83, 0.95] and 0.81, 95% CI [0.71, 0.89], respectively. The CCC and ICC for v-EASI were 0.75, 95% CI [0.63, 0.88] and 0.69, 95% CI [0.51, 0.81], respectively. In this diverse population with a range of skin tones, p-EASI showed good criterion validity and good interrater reliability. v-EASI showed moderate to good criterion validity and moderate interrater reliability. Both may be reliable and valid options for remote AD severity assessment.

Sections du résumé

BACKGROUND/OBJECTIVES OBJECTIVE
We sought to quantify the reliability and validity of remote atopic dermatitis (AD) severity assessment using the Eczema Area and Severity Index (EASI) applied to caregiver-provided photos (p-EASI) and videos (v-EASI).
METHODS METHODS
Children (0-17 years) with a physician diagnosis of AD were recruited. Caregivers took photos and a video of their child's skin. A clinician scored in-person EASI on the same day, then p-EASI and v-EASI for each participant 10 days or more between ratings. Two additional clinicians scored p-EASI and v-EASI. Lin's concordance correlation coefficient (CCC) was employed to assess criterion validity using in-person EASI as the gold standard. Intraclass correlation coefficients (ICCs) were calculated to assess interrater reliability of p-EASI and v-EASI.
RESULTS RESULTS
Fifty racially and ethnically diverse children (age [mean ± SD]: 4.3 ± 4.4 years; 42% female) with a range of AD severity (EASI: 6.3 ± 6.4) and Fitzpatrick skin types (1-2: 9%; 3-4: 60%; 5-6: 31%) were enrolled and received in-person EASI assessment. Fifty had p-EASI and 49 had v-EASI by the same in-person rater, and by two additional raters. The CCC and ICC for p-EASI were 0.89, 95% CI [0.83, 0.95] and 0.81, 95% CI [0.71, 0.89], respectively. The CCC and ICC for v-EASI were 0.75, 95% CI [0.63, 0.88] and 0.69, 95% CI [0.51, 0.81], respectively.
CONCLUSIONS CONCLUSIONS
In this diverse population with a range of skin tones, p-EASI showed good criterion validity and good interrater reliability. v-EASI showed moderate to good criterion validity and moderate interrater reliability. Both may be reliable and valid options for remote AD severity assessment.

Identifiants

pubmed: 35522088
doi: 10.1111/pde.15003
pmc: PMC9420774
mid: NIHMS1795293
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

547-552

Subventions

Organisme : NIEHS NIH HHS
ID : R01 ES026170
Pays : United States
Organisme : NIH HHS
ID : R01ES023447
Pays : United States
Organisme : Pfizer
ID : Dermatology Research Fellowship
Organisme : NIEHS NIH HHS
ID : R01 ES023447
Pays : United States
Organisme : NIH HHS
ID : R01ES026170
Pays : United States
Organisme : Dell Medical School at The University of Texas at Austin
ID : Core Funds
Organisme : Pediatric Dermatology Research Alliance
ID : Research Fellowship Grant
Organisme : NINR NIH HHS
ID : T32NR019035
Pays : United States
Organisme : NIH HHS
ID : K24AI114769
Pays : United States
Organisme : NINR NIH HHS
ID : T32 NR019035
Pays : United States
Organisme : NIAID NIH HHS
ID : K24 AI114769
Pays : United States

Informations de copyright

© 2022 Wiley Periodicals LLC.

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Auteurs

Emily A Croce (EA)

Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.
The University of Texas at Austin School of Nursing, Austin, Texas, USA.

Paul J Rathouz (PJ)

Department of Population Health, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.

Fabiana C P S Lopes (FCPS)

Department of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.

Maria Leszczynska (M)

Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.

Lucia Z Diaz (LZ)

Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.
Department of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.
Department of Pediatrics, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.

Moise L Levy (ML)

Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.
Department of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.
Department of Pediatrics, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.

Jennifer S Ruth (JS)

Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.
Department of Internal Medicine, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.
Department of Pediatrics, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.

Pooja Varshney (P)

Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.
Department of Pediatrics, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.

Lynn Rew (L)

The University of Texas at Austin School of Nursing, Austin, Texas, USA.

Elizabeth C Matsui (EC)

Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.
Department of Population Health, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.
Department of Pediatrics, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA.

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