Validation of the German Pruritus Questionnaire for the systematic assessment of chronic pruritus.
Itch
Pruritus
Quality of life
Questionnaire
patient reported outcomes
Journal
Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
ISSN: 1610-0387
Titre abrégé: J Dtsch Dermatol Ges
Pays: Germany
ID NLM: 101164708
Informations de publication
Date de publication:
26 Jun 2024
26 Jun 2024
Historique:
received:
26
10
2023
accepted:
21
03
2024
medline:
27
6
2024
pubmed:
27
6
2024
entrez:
27
6
2024
Statut:
aheadofprint
Résumé
Chronic pruritus is a clinically heterogeneous symptom that manifests itself with varying duration, intensity, or quality. To date, there is no validated German-language instrument that systematically assesses the relevant parameters. With the support of the Pruritus Research Working Group (Arbeitsgemeinschaft Pruritusforschung, AGP), a questionnaire for the assessment of chronic pruritus (AGP questionnaire) was developed in 2008. The subsequently revised instrument, now called the German Pruritus Questionnaire, records pruritus-specific parameters such as localization, course, intensity and quality, anamnestic data on the general state of health, sociodemographic data, quality of life, and coping methods. It is to be validated in the study presented here. The questionnaire was used in 366 patients with chronic pruritus of different etiologies from Germany (University Hospitals Heidelberg, Münster, Mainz, Erlangen, Giessen, private practice Bad Bentheim, TU Munich, Wiesbaden Kidney Center), Austria (Graz University Hospital) and Switzerland (Aarau Cantonal Hospital). The reliability for repeated completion (retest reliability) with regard to localization, first occurrence, and concomitant diseases showed high values for Cohen's kappa (> 0.8). The data on the retest reliability of the pruritus characteristics showed lower values (< 0.7). With regard to the measurability of practically relevant changes (change sensitivity), medium to strong effect sizes were found (0.09-0.19). A statistically significant differentiation of the pruritus etiologies based on the recorded parameters was not possible. The German Pruritus Questionnaire allows a comprehensive and structured recording of patient- and clinician-reported, relevant dimensions of chronic pruritus of different etiologies. Further adaptation and development are planned.
Sections du résumé
BACKGROUND
BACKGROUND
Chronic pruritus is a clinically heterogeneous symptom that manifests itself with varying duration, intensity, or quality. To date, there is no validated German-language instrument that systematically assesses the relevant parameters. With the support of the Pruritus Research Working Group (Arbeitsgemeinschaft Pruritusforschung, AGP), a questionnaire for the assessment of chronic pruritus (AGP questionnaire) was developed in 2008. The subsequently revised instrument, now called the German Pruritus Questionnaire, records pruritus-specific parameters such as localization, course, intensity and quality, anamnestic data on the general state of health, sociodemographic data, quality of life, and coping methods. It is to be validated in the study presented here.
PATIENTS AND METHODS
METHODS
The questionnaire was used in 366 patients with chronic pruritus of different etiologies from Germany (University Hospitals Heidelberg, Münster, Mainz, Erlangen, Giessen, private practice Bad Bentheim, TU Munich, Wiesbaden Kidney Center), Austria (Graz University Hospital) and Switzerland (Aarau Cantonal Hospital).
RESULTS
RESULTS
The reliability for repeated completion (retest reliability) with regard to localization, first occurrence, and concomitant diseases showed high values for Cohen's kappa (> 0.8). The data on the retest reliability of the pruritus characteristics showed lower values (< 0.7). With regard to the measurability of practically relevant changes (change sensitivity), medium to strong effect sizes were found (0.09-0.19). A statistically significant differentiation of the pruritus etiologies based on the recorded parameters was not possible.
CONCLUSIONS
CONCLUSIONS
The German Pruritus Questionnaire allows a comprehensive and structured recording of patient- and clinician-reported, relevant dimensions of chronic pruritus of different etiologies. Further adaptation and development are planned.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Author(s). Journal der Deutschen Dermatologischen Gesellschaft published by John Wiley & Sons Ltd on behalf of Deutsche Dermatologische Gesellschaft.
Références
Ständer S, Weisshaar E, Mettang T, et al. Clinical classification of itch: a position paper of the International Forum for the Study of Itch. Acta Derm Venereol. 2007;87(4):291‐294.
Matterne U, Apfelbacher CJ, Loerbroks A, et al. Prevalence, correlates and characteristics of chronic pruritus: a population‐based cross‐sectional study. Acta Derm Venereol. 2011;91(6):674‐679.
Matterne U, Apfelbacher CJ, Vogelgsang L, et. al. Incidence and determinants of chronic pruritus: a population‐based cohort study. Acta Derm Venereol. 2013;93(5):532‐537.
Stewart TJ, Schut C, Whitfeld M, Yosipovitch G. Cross‐sectional study of psychological stress and skin symptoms in Australian university students. Australas J Dermatol. 2018;59(1):e82‐e84.
Schut C, Bosbach S, Gieler U, Kupfer J. Personality traits, depression and itch in patients with atopic dermatitis in an experimental setting: a regression analysis. Acta Derm Venereol. 2014;94(1):20‐25.
Ogden J, Zoukas S. Generating physical symptoms from visual cues: An experimental study. Psychol Health Med. 2009;14(6):695‐704.
Dalgard FJ, Svensson A, Halvorsen JA, et al. Itch and Mental Health in Dermatological Patients across Europe: A Cross‐Sectional Study in 13 Countries. J Invest Derm. 2020;140(3):568‐573.
Ständer S, Blome C, Breil B, et al. [Assessment of pruritus ‐ current standards and implications for clinical practice: consensus paper of the Action Group Pruritus Parameter of the International Working Group on Pruritus Research (AGP)]. Hautarzt. 2012;63(7):521‐522, 524–531.
Dominick F, van Laarhoven A, Evers A, Weisshaar E. A systematic review of questionnaires on itch by the Special Interest Group “Questionnaires” of the International Forum for the Study of Itch (IFSI). Itch. 2019;4(3):e26.
Weisshaar E, Stander S, Gieler U,et al. [Development of a German language questionnaire for assessing chronic pruritus (AGP‐questionnaire): background and first results]. Hautarzt. 2011;62(12):914‐927.
Ständer S, Zeidler C, Augustin M, et al. S2k Leitlinie: Diagnostik und Therapie des chronischen Pruritus. J Dtsch Dermatol Ges. 2022;20(10):1386‐14402.
Rosellini AJ, Brown TA. Developing and Validating Clinical Questionnaires. Annu Rev Clin Psychol. 2021;17:55‐81.
Krause K, Kessler B, Weller K, et al. German version of ItchyQoL: validation and initial clinical findings. Acta Derm Venereol. 2013;93(5):562‐568.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373‐383.
Stander S, Weisshaar E, Mettang T, et al. Clinical classification of itch: a position paper of the International Forum for the Study of Itch. Acta Derm Venereol. 2007;87(4):291‐294.
Cohen J. Statistical power analysis for the behavioral sciences. 2nd (ed). Hillsdale: Lawrence Erlbaum Associates, 1988.
Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159‐174.
Lord F. The relation of the reliability of multiple‐choice tests to the distribution of item difficulties. Psychometrika. 1952;17(2):181‐194.
Bathe A, Weisshaar E, Matterne U. Chronic pruritus–more than a symptom: a qualitative investigation into patients' subjective illness perceptions. J Adv Nurs. 2013;69(2):316‐326.
Weisshaar E, Gieler U, Kupfer J, et al. Questionnaires to assess chronic itch: a consensus paper of the special interest group of the International Forum on the Study of Itch. Acta Derm Venereol. 2012;92(5):493‐496.