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Foley P, Mahar PD, Smith SD, Gupta M, Manuelpillai N, Orchard D, Wong LC, Su JC, James A, Fischer G, Marshman G, Rawlin M, Turner M, King E, Kennedy R, Baker C. Australian consensus: Treatment goals for moderate to severe psoriasis in the era of targeted therapies - Considerations for paediatric patients. Australas J Dermatol 2024. [PMID: 38741474 DOI: 10.1111/ajd.14303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/14/2024] [Accepted: 04/28/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Treatment goals have been established in Australia to facilitate the management of adults with moderate to severe psoriasis. The Australasian College of Dermatologists sought to determine if and how these adult treatment goals could be modified to accommodate the needs of paediatric and adolescent patients. METHODS A modified Delphi approach was used. Comprehensive literature review and guideline evaluation resulted in the development of statements and other questions to establish current clinical practices. Two rounds of anonymous voting were undertaken, with a collaborative meeting held in between to discuss areas of discordance. Overall, consensus was defined as achievement of ≥75% agreement in the range 7-9 on a 9-point scale (1 strongly disagree; 9 strongly agree). RESULTS Consensus was achieved on 23/29 statements in round 1 and 17/18 statements in round 2. There was a high level of concordance with treatment criteria in the adult setting. The limitations of applying assessment tools developed for use in adult patients to the paediatric setting were highlighted. Treatment targets in the paediatric setting should include objective metrics for disease severity and psychological impact on the patients and their family, and be based on validated, age-appropriate tools. CONCLUSION While the assessment, classification and management of moderate to severe psoriasis in paediatric patients aligns with metrics established for adults, it is vital that nuances in the transition from childhood to adolescence be taken into account. Future research should focus on psoriasis severity assessment scales specific to the paediatric setting.
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Affiliation(s)
- Peter Foley
- Skin Health Institute, Carlton, Victoria, Australia
- Department of Dermatology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Patrick D Mahar
- Skin Health Institute, Carlton, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Saxon D Smith
- Sydney Adventist Hospital Clinical School, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia
- The Dermatology and Skin Cancer Centre, St Leonards, New South Wales, Australia
| | - Monisha Gupta
- Department of Dermatology, Liverpool Hospital, Liverpool, New South Wales, Australia
- The Skin Hospital, Westmead, New South Wales, Australia
- The University of New South Wales, Sydney, New South Wales, Australia
- Western Sydney University, Sydney, New South Wales, Australia
| | - Nicholas Manuelpillai
- Department of Dermatology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - David Orchard
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia
- Barkers Road Dermatology, Kew, Victoria, Australia
| | - Li-Chuen Wong
- Royal Prince Alfred Hospital Medical Centre, Newtown, New South Wales, Australia
- Department of Dermatology, Children's Hospital, Westmead, New South Wales, Australia
- The University of Sydney, Camperdown, New South Wales, Australia
| | - John C Su
- The University of Melbourne, Melbourne, Victoria, Australia
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia
- Eastern Health, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Amelia James
- Department of Dermatology, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Gayle Fischer
- The University of Sydney, Camperdown, New South Wales, Australia
- Department of Dermatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Gillian Marshman
- Dermatology Clinic, Flinders Medical Centre, Adelaide, South Australia, Australia
- Willan House Dermatology, Brighton, South Australia, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Morton Rawlin
- Macedon Medical Centre, Templestowe Lower, Victoria, Australia
| | | | - Emma King
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Robyn Kennedy
- Department of Dermatology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Christopher Baker
- Skin Health Institute, Carlton, Victoria, Australia
- Department of Dermatology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- The University of Melbourne, Melbourne, Victoria, Australia
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Pascual MG, Schmiege SJ, Manson SM, Kohn LL. Comparison of the Skindex-Teen and the Skindex-29 quality of life survey instruments in a predominantly American Indian adolescent population. Pediatr Dermatol 2024. [PMID: 38532574 DOI: 10.1111/pde.15592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 02/24/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND/OBJECTIVES The Skindex-29 and Skindex-Teen assess dermatology-related quality of life among adults and adolescents, respectively. This study directly compared the same adolescents' responses to the Skindex-29 relative to Skindex-Teen in a predominantly American Indian and/or Alaska Native population. This population is underrepresented in medical research. Although skin-related quality-of-life issues are widespread, American Indian and/or Alaska Native adolescents are not well-represented in related studies. METHODS Data were collected in-person by self-report survey at two regional powwows in Denver, Colorado in 2021 and 2022. Respondents completed the full Skindex-29 and Skindex-Teen (40 unique items total). RESULTS Eighty-six adolescents, 12-17 years old, completed the survey. The majority (70.9%, 61/86) of respondents self-identified as American Indian and/or Alaska Native. Analyses were conducted with all respondent survey data. Nearly two-thirds (64.0%, 55/86) of our respondents had a Skindex-29 score that revealed their quality of life was impaired at least mildly by skin disease. The Skindex-29 and Skindex-Teen demonstrated good reliability; there was substantial concordance between responses to the two measures (r values ranged from 0.88 to 0.97 for similar subscales). Compared to younger adolescents (aged 12-14), older adolescents (aged 15-17) reported worse dermatology-related quality of life and emotional toll based on higher Skindex-29 total, Skindex-Teen total, Skindex-29 Emotional subscale, and Skindex-Teen Psychosocial Functioning subscale scores. CONCLUSIONS American Indian and/or Alaska Native adolescents suffer from skin-related quality-of-life issues. The Skindex-Teen and Skindex-29 generated similar information regarding quality of life in young patients with skin disease. While the Skindex-Teen may be slightly more relevant to adolescents, these surveys were highly concordant. Both the Skindex-Teen and Skindex-29 exhibited frequent "never" responses to questions about impact of skin conditions on relationships with others and tendencies to stay home. Thus, careful attention should be paid to such questions to ensure their relevance to adolescents.
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Affiliation(s)
- Micah G Pascual
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Sarah J Schmiege
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Spero M Manson
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Psychiatry, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Community & Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Lucinda L Kohn
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado, USA
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3
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Lorini L, Alberti A, Bossi P. Advanced Cutaneous Squamous Cell Carcinoma Management in Immunotherapy Era: Achievements and New Challenges. Dermatol Pract Concept 2023; 13:dpc.1304a251. [PMID: 37992352 PMCID: PMC10656166 DOI: 10.5826/dpc.1304a251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 11/24/2023] Open
Abstract
Introduction of immunotherapy (IT) has radically changed the therapeutic scenario in patients affected by locally advanced and/or metastatic cutaneous squamous cell carcinoma (cSCC) patients. If it is well consolidated the role of immunotherapy in the setting of a disease not amenable to curative surgery and/or radiation, how to integrate immune checkpoint inhibitors in the curative setting is still under evaluation. Surgery combined or not with adjuvant radiotherapy remains the mainstay of curative treatment in localized cSCC; however, promising data with neoadjuvant or perioperative immunotherapy could pave the way towards treatment de-escalation according to the response achieved. On the other side, data on adjuvant treatment with pembrolizumab and cemiplimab after surgery and radiation are still awaited. Several questions related to the activity and the safety of immunotherapy in the real-world setting still remain without answer, and several points need to be better explored. In the current review we will explore the updated literature on the use of immunotherapy in cSCC, and we will show the current challenges in its use.
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Affiliation(s)
- Luigi Lorini
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy
| | - Andrea Alberti
- Medical Oncology Unit, Department of Medical & Surgical Specialties, Radiological Sciences & Public Health, University of Brescia, ASST Spedali Civili, Brescia, Italy
| | - Paolo Bossi
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano (Milan), Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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McPherson T, Ravenscroft J, Ali R, Barlow R, Beattie P, Bewley A, Bennett S, Bleiker T, Buckley L, Burgess G, Copperwheat S, Cunliffe T, Dejong H, Fazel M, Heyman I, Howard E, Lambert A, Manktelow C, Moledina Z, Mohandas P, Moss C, Northover G, Paz I, Proctor A, Roxborough C, Shibib S, Solman L, Srinivasan J, Wood D, Baron S. British Society for Paediatric and Adolescent Dermatology assessment and support of mental health in children and young people with skin conditions: a multidisciplinary expert consensus statement and recommendations. Br J Dermatol 2023; 189:459-466. [PMID: 37291902 DOI: 10.1093/bjd/ljad193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Psychological and mental health difficulties are common in children and young people (CYP) living with skin conditions and can have a profound impact on wellbeing. There is limited guidance on how best to assess and support the mental health of this population, who are at risk of poor health outcomes. OBJECTIVES To provide consensus-based recommendations on the assessment and monitoring of and support for mental health difficulties in CYP with skin conditions (affecting the skin, hair and nails); to address practical clinical implementation questions relating to consensus guidance; and to provide audit and research recommendations. METHODS This set of recommendations was developed with reference to the AGREE II instrument. A systematic review and literature appraisal was carried out. A multidisciplinary consensus group was convened, with two virtual panel meetings held: an initial meeting to discuss the scope of the study, to review the current evidence and to identify areas for development; and a second meeting to agree on the content and wording of the recommendations. Recommendations were then circulated to stakeholders, following which amendments were made and agreed by email. RESULTS The expert panel achieved consensus on 11 recommendations for healthcare workers managing CYP with skin conditions. A new patient-completed history-taking aid ('You and Your Skin') was developed and is being piloted. CONCLUSIONS The recommendations focus on improved mental health assessments for CYP presenting with a skin condition, with clinical guidance and suggested screening measures included. Information on accessing psychological support for CYP, when required, is given, and recommendations for staff training in mental health and neurodiversity provided. Embedding a psychosocial approach within services treating CYP with skin disease should ensure that CYP with psychological needs are able to be identified, listened to, supported and treated. This is likely to improve health outcomes.
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Affiliation(s)
- Tess McPherson
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jane Ravenscroft
- Department of Dermatology, Nottingham University Hospital, Nottingham, UK
- Centre for Evidence Based Dermatology, Nottingham University, Nottingham, UK
| | - Rukshana Ali
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Richard Barlow
- Department of Dermatology, Birmingham City Hospital, Birmingham, UK
| | - Paula Beattie
- Department of Dermatology, Royal Hospital for Children, Glasgow, UK
| | - Anthony Bewley
- Department of Dermatology, Barts Health NHS Trust, London, UK
- Department of Dermatology, Queen Mary University London, London, UK
| | - Sophie Bennett
- Great Ormond Street Hospital for Children NHS Foundation Trust, Health, London, UK
| | - Tanya Bleiker
- Department of Dermatology, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Liz Buckley
- Department of Paediatric Dermatology, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham, UK
| | - Gary Burgess
- Great Ormond Street Hospital for Children NHS Foundation Trust, Health, London, UK
| | - Sarah Copperwheat
- Department of Dermatology, Sussex Community NHS Foundation Trust, Brighton, UK
| | - Tim Cunliffe
- Primary Care, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
| | - Hannah Dejong
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Mina Fazel
- University of Oxford, Oxford, UK
- Oxford Psychological Medicine Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Isobel Heyman
- Great Ormond Street Hospital for Children NHS Foundation Trust, Health, London, UK
| | - Emma Howard
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Claire Manktelow
- University of Nottingham Health Service, Cripps Health Centre, Nottingham, UK
| | | | - Padma Mohandas
- Department of Dermatology, Barts Health NHS Trust, London, UK
| | - Celia Moss
- Department of Dermatology, Birmingham Children's Hospital, Birmingham, UK
| | | | - Isabel Paz
- University of Oxford, Oxford, UK
- Oxford Psychological Medicine Centre, Oxford Health NHS Foundation Trust Psychological Services, Oxford, UK
| | | | | | - Shatha Shibib
- Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| | - Lea Solman
- Great Ormond Street Hospital for Children NHS Foundation Trust, Health, London, UK
| | - Jo Srinivasan
- Department of Paediatric Dermatology, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham, UK
| | - Damian Wood
- Department of Paediatric Dermatology, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham, UK
| | - Susannah Baron
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Current Utilization of Qualitative Methodologies in Dermatology: A Scoping Review. JID INNOVATIONS 2023; 3:100172. [PMID: 36891031 PMCID: PMC9986021 DOI: 10.1016/j.xjidi.2022.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/27/2022] [Accepted: 10/03/2022] [Indexed: 11/19/2022] Open
Abstract
The focus of this review was to determine how qualitative methods are used in dermatology research and whether published manuscripts meet current standards for qualitative research. A scoping review of manuscripts published in English between January 1, 2016 and September 22, 2021 was conducted. A coding document was developed to collect information on authors, methodology, participants, research theme, and the presence of quality criteria as outlined by the Standards for Reporting Qualitative Research. Manuscripts were included if they described original qualitative research about dermatologic conditions or topics of primary interest to dermatology. An adjacency search yielded 372 manuscripts, and after screening, 134 met the inclusion criteria. Most studies utilized interviews or focus groups, and researchers predominantly selected participants on the basis of disease status, including over 30 common and rare dermatologic conditions. Research themes frequently included patient experience of disease, development of patient-reported outcomes, and descriptions of provider and caregiver experiences. Although most authors explained their analysis and sampling strategy and included empirical data, few referenced qualitative data reporting standards. Missed opportunities for qualitative methods in dermatology include examination of health disparities, exploration of surgical and cosmetic dermatology experiences, and determination of the lived experience of and provider attitudes toward diverse patient populations.
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Alonso-Naranjo L, Berna-Rico E, Blanco Abbad-Jaime de Aragón C, Castañeda-Vozmediano R, Prieto-López L, Sánchez-Moya AI, Pérez-Hortet C, González-Cantero Á. Spanish Version of Teenagers' Quality of Life (T-QoL) for Adolescents with Skin Diseases: Translation, Cultural Adaptation and Validation. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:299-307. [PMID: 36690147 DOI: 10.1016/j.ad.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/11/2023] [Accepted: 01/15/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Teenagers' Quality of Life (T-QoL) is an age-specific measure to assess QoL of teenagers suffering from different skin diseases. A validated Spanish language version is lacking. We present the translation, cultural adaptation and validation of the T-QoL into Spanish. METHODS A prospective study with 133 patients (between 12 and 19 years old), attended at the dermatology department of Toledo University Hospital, Spain (September 2019-May 2020), was carried out for the validation study. The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines were used for the translation and cultural adaptation. We evaluated the convergent validity with the Dermatology Life Quality Index (DLQI), the Children's Dermatology Life Quality Index (CDLQI) and with a Global Question (GQ) on self-assessed disease severity. We also analysed internal consistency and reliability of the T-QoL tool and confirmed its structure with a factor analysis. RESULTS Global T-QoL scores significantly correlated with the DLQI and the CDLQI (r=0.75) and with the GQ (r=0.63). The confirmatory factor analysis showed optimal fit for the bi-factor model and an adequate fit for the correlated three-factor model. Reliability indicators were high (Cronbach's α=0.89; Guttman's Lambda 6 index=0.91; Omega ω=0.91) and test-retest showed a high stability (ICC=0.85). The results were consistent with those found by the authors of the original test. CONCLUSION Our Spanish version of the T-QoL tool is valid and reliable to assess QoL of Spanish-speaking adolescents with skin diseases.
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Affiliation(s)
- L Alonso-Naranjo
- Department of Dermatology, Hospital Universitario de Toledo, Toledo, Spain
| | - E Berna-Rico
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | | | - L Prieto-López
- Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - A I Sánchez-Moya
- Department of Dermatology, Hospital Universitario de Toledo, Toledo, Spain
| | - C Pérez-Hortet
- Department of Dermatology, Hospital Universitario de Toledo, Toledo, Spain
| | - Á González-Cantero
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain.
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Neale H, Schrandt S, Abbott BM, Austin J, Brand C, Camp K, Devenport K, Hall M, Isbell L, Miciano C, Pry S, Quinn P, Rittle J, Tenconi F, Terrell J, Weiss M, Zavitz S, Siegel M. Defining patient-centered research priorities in pediatric dermatology. Pediatr Dermatol 2022; 40:250-257. [PMID: 36443263 DOI: 10.1111/pde.15199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Patient and caregiver perspectives are critical in understanding dermatologic disease impact, presentation, and management in children. The Pediatric Dermatology Research Alliance (PeDRA) Patient Advisory Committee (PtAC), a group of patient representatives and parents of children with cutaneous disease, pursued a multistep, iterative, consensus-building process to identify comprehensive, high-priority research needs. METHODS Building on discussions at the 2020 PeDRA Annual Conference, a research prioritization survey was developed and completed by PtAC members. Survey themes were aggregated and workshopped by the PtAC through a series of facilitated calls. Emerging priorities were refined in collaboration with additional PeDRA patient community members at the 2021 PeDRA Annual Conference. Subsequently, a final actionable list was agreed upon. RESULTS Fourteen PtAC members (86.7% female) representing patients with alopecia areata, atopic dermatitis, vascular birthmarks, congenital melanocytic nevi, ectodermal dysplasias, epidermolysis bullosa, Gorlin syndrome, hidradenitis suppurativa, ichthyosis, pemphigus, psoriasis, Sturge-Weber syndrome, and pachyonychia congenita completed the survey. Following serial PtAC meetings, 60 research needs were identified from five domains: psychosocial challenges, health care navigation/disease management, causes/triggers, treatments to preserve or save life, and treatments to preserve or save quality of life. CONCLUSIONS Many pediatric dermatology research priorities align across affected communities and may drive meaningful, patient-centric initiatives and investigations.
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Affiliation(s)
- Holly Neale
- Pediatric Dermatology Research Alliance, Portland, Oregon, USA.,University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | - Becky M Abbott
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,National Foundation for Ectodermal Dysplasias, Fairview Heights, Illinois, USA
| | - Jennifer Austin
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,International Alliance of Dermatology Patient Organizations, Ottawa, Ontario, Canada
| | - Callista Brand
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,HS Foundation, Santa Monica, California, USA
| | - Karen Camp
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA
| | | | - Michelle Hall
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,EB Research Partnership, New York, New York, USA
| | - Lauren Isbell
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,Nevus Outreach, Jonesboro, Arkansas, USA
| | - Charlene Miciano
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,National Eczema Association, San Rafael, California, USA
| | - Sarah Pry
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,Global Parents for Eczema Research, Santa Barbara, California, USA
| | - Paula Quinn
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,National Alopecia Areata Foundation, San Rafael, California, USA
| | - James Rittle
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,Pachyonychia Congenita Project, Holladay, Utah, USA
| | - Francesca Tenconi
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,Children's Skin Disease Foundation, Walnut Creek, California, USA
| | - Julia Terrell
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,The Sturge-Weber Foundation, Randolph, New Jersey, USA
| | - Meredith Weiss
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,Gorlin Syndrome Alliance, Reading, Pennsylvania, USA
| | - Sam Zavitz
- Pediatric Dermatology Research Alliance Patient Advisory Committee (PeDRA-PtAC), Portland, Oregon, USA.,Foundation for Ichthyosis and Related Skin Types, Colmar, Pennsylvania, USA
| | - Michael Siegel
- Pediatric Dermatology Research Alliance, Portland, Oregon, USA
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8
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Kong HE, Francois S, Smith S, Lee G, Bradley B, Chen KH, Lawley LP, Spraker M, Roberts JS, Chen SC. Tools to study the severity of itch in 8- to 17-year-old children: Validation of TweenItchyQoL and ItchyQuant. Pediatr Dermatol 2021; 38:1118-1126. [PMID: 34339533 DOI: 10.1111/pde.14662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND/OBJECTIVES Validated pruritus-specific quality of life and self-reported severity instruments exist primarily for adults. Clinical trials to develop therapeutics for children with chronic pruritus are hampered by the paucity of appropriate outcome measures. To address this gap, we aimed to develop validated instruments to measure itch-specific quality of life and self-reported severity in children. METHODS We conducted in-depth, open-ended interviews of itchy children and generated concepts to develop TweenItchyQoL. We administered TweenItchyQoL, ItchyQuant, a cartoon-annotated self-reported pruritus severity numeric rating scale (NRS), and a non-cartoon NRS to 175 itchy children aged 8-17 years. We analyzed the data for feasibility, preference, reliability, construct validity, and responsiveness. RESULTS Average completion time was 4.8 minutes for TweenItchyQoL and 33 seconds for ItchyQuant. The majority of patients either preferred ItchyQuant or found no difference between ItchyQuant and the NRS. Cronbach's alpha for TweenItchyQoL total and subscales ranged from 0.84 to 0.95. Test-retest reliability coefficients were ≥0.7 for TweenItchyQoL and 0.4 for ItchyQuant. A 3-dimensional bifactor model was most appropriate (RMSEA = 0.048) on the confirmatory factor analyses. As a function of those reporting worsening, improvement, or no change at their final visit, TweenItchyQoL and ItchyQuant scores in those cohorts changed as expected. CONCLUSIONS This new set of validated and feasible instruments shows promise to quantify itch severity and QoL impact in older children.
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Affiliation(s)
- Ha Eun Kong
- Emory University School of Medicine, Atlanta, GA, USA
| | | | - Shelby Smith
- Emory University School of Medicine, Atlanta, GA, USA
| | - Grace Lee
- Emory University School of Medicine, Atlanta, GA, USA
| | | | - Kuang-Ho Chen
- Emory University School of Medicine, Atlanta, GA, USA
| | | | - Mary Spraker
- Emory University School of Medicine, Atlanta, GA, USA
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9
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Rencz F, Szabó Á, Brodszky V. Questionnaire Modifications and Alternative Scoring Methods of the Dermatology Life Quality Index: A Systematic Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1158-1171. [PMID: 34372982 DOI: 10.1016/j.jval.2021.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 01/02/2021] [Accepted: 02/16/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Dermatology Life Quality index (DLQI) is the most widely used health-related quality of life questionnaire in dermatology. Little is known about existing questionnaire or scoring modifications of the DLQI. We aimed to systematically review, identify, and categorize all modified questionnaire versions and scoring methods of the DLQI. METHODS We performed a systematic literature search in PubMed, Web of Science, CINAHL, and PsychINFO. Methodologic quality and evidence of psychometric properties were assessed using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) and Terwee checklists. RESULTS The included 81 articles reported on 77 studies using 59 DLQI modifications. Modifications were used for a combined sample of 25 509 patients with 47 different diagnoses and symptoms from 28 countries. The most frequently studied diseases were psoriasis, hirsutism, acne, alopecia, and bromhidrosis. The modifications were categorized into the following nonmutually exclusive groups: bolt-ons or bolt-offs (48%), disease, symptom, and body part specifications (42%), changes in existing items (34%), scoring modifications (27%), recall period changes (19%), response scale modifications (15%), and illustrations (3%). The evidence concerning the quality of measurement properties was heterogeneous: 4 of 13 studies were rated positive on internal consistency, 1 of 3 on reliability, 3 of 5 on content validity, 9 of 22 on construct validity, 6 of 6 on criterion validity, and 1 of 1 on responsiveness. CONCLUSION An exceptionally large number of DLQI modifications have been used that may indicate an unmet need for adequate health-related quality of life instruments in dermatology. The psychometric overview of most questionnaire modifications is currently incomplete, and additional efforts are needed for proper validation.
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Affiliation(s)
- Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; Hungarian Academy of Sciences, Premium Postdoctoral Research Programme, Budapest, Hungary.
| | - Ákos Szabó
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary; Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
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10
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Abdelrazik YT, Ali FM, Salek MS, Finlay AY. Clinical experience and psychometric properties of the Cardiff Acne Disability Index (CADI). Br J Dermatol 2021; 185:711-724. [PMID: 33864247 DOI: 10.1111/bjd.20391] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 01/01/2023]
Abstract
The Cardiff Acne Disability Index (CADI) is a questionnaire designed to measure the quality of life of teenagers and young adults with acne. It has been used clinically and within therapeutic research globally. This review aims to appraise all published data regarding the clinical and research experience of the CADI, its psychometric properties and validation, from its publication in 1992 until September 2020, in a single reference source. A literature search was conducted using MEDLINE via Ovid, PubMed, EBSCOhost, Web of Science and Scopus. All full articles in the English language were included. A total of 96 clinical studies were identified and analysed. The CADI has been used in 44 different countries, including four multinational studies, and has validated translations in 25 languages. Overall, 29 therapeutic interventions have used the CADI, demonstrating its responsiveness to change. The reliability of the CADI has been assessed in 14 studies through test-retest and internal consistency studies. In total, 57 studies have demonstrated aspects of its validity through correlation to other measures, and five studies have investigated the dimensionality of the CADI. There is evidence of high internal consistency, test-retest reliability, responsiveness to change and significant correlation with other objective measures. The minimal clinically important difference and validated score meaning bands have not yet been reported. This information is needed to improve the interpretability of CADI scores for clinical use and in research. The authors of the CADI have also rephrased Question 2 of the measure to ensure inclusivity.
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Affiliation(s)
- Y T Abdelrazik
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
| | - F M Ali
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
| | - M S Salek
- Department of Pharmacy, Pharmacology and Postgraduate Medicine, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - A Y Finlay
- Division of Infection and Immunity, Cardiff University School of Medicine, Cardiff, UK
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11
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Dabaghi S, Esmaielzadeh F, Rohani C. Application of Rasch Analysis for Development and Psychometric Properties of Adolescents' Quality of Life Instruments: A Systematic Review. Adolesc Health Med Ther 2020; 11:173-197. [PMID: 33204203 PMCID: PMC7666979 DOI: 10.2147/ahmt.s265413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 10/20/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Due to the importance of assessing quality of life (QoL) in healthy and ill adolescents, the evaluation of psychometric properties of these questionnaires is important. OBJECTIVE To investigate the application of Rasch analysis in psychometric assessment studies on adolescents' QoL instruments, and to evaluate the quality of reporting Rasch parameters in these studies. METHODS This systematic review was conducted by searching for papers in electronic databases PubMed, Web of Science, EMBASE, Cochrane Library and Scopus until December 2018. RESULTS After screening 122 papers, 31 remained in the study. Around 68% of the studies used the Rasch analysis for instrument testing and 32% for the development of new instruments. In 77.4% of studies, both classical and Rasch methods were used parallel to data analysis. In 32.2% of studies, healthy adolescents were the main target group. The most commonly used instrument in Rasch studies was, KIDSCREEN, administered in different countries. Six Rasch parameters were reported with a higher percentage in the studies. Major reported parameters of Rasch analysis were application of the software program (96.7%), test of item fit to the Rasch model (93.5%), unidimensionality (80.6%), type of the identified mathematical Rasch model (74.1%), threshold (58%) and differential item functioning (54.8%). Based on the psychometric evaluation of the QoL instruments, 71% of studies showed acceptable results. CONCLUSION The application of the Rasch model for psychometric assessment of adolescents' QoL questionnaires has increased in recent decades. But, there is still no strong and commonly used critical appraisal tool or guideline for the evaluation of these papers.
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Affiliation(s)
- Sahar Dabaghi
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Esmaielzadeh
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Camelia Rohani
- Community Health Nursing Department, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Ersta Sköndal Bräcke University College, Campus Ersta, StockholmSE-100 61, Sweden
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12
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Assessing the engagement of children and families in selecting patient-reported outcomes (PROs) and developing their measures: a systematic review. Qual Life Res 2020; 30:983-995. [DOI: 10.1007/s11136-020-02690-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 01/14/2023]
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13
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Husbands S, Mitchell PM, Coast J. A Systematic Review of the Use and Quality of Qualitative Methods in Concept Elicitation for Measures with Children and Young People. THE PATIENT 2020; 13:257-288. [PMID: 32346817 PMCID: PMC7210227 DOI: 10.1007/s40271-020-00414-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Qualitative research is recommended in concept elicitation for patient-reported outcome measures to ensure item content validity, and those developing measures are encouraged to report qualitative methods in detail. However, in measure development for children and young people, direct research can be challenging due to problems with engagement and communication. OBJECTIVES The aim of this systematic review was to (i) explore the qualitative and adapted data collection techniques that research teams have used with children and young people to generate items in existing measures and (ii) assess the quality of qualitative reporting. METHODS Three electronic databases were searched with forward citation and reference list searching of key papers. Papers included in the review were empirical studies documenting qualitative concept elicitation with children and young people. Data on qualitative methods were extracted, and all studies were checked against a qualitative reporting checklist. RESULTS A total of 37 studies were included. The quality of reporting of qualitative approaches for item generation was low, with information missing on sampling, data analysis and the research team, all of which are key to facilitating judgements around measure content validity. Few papers reported adapting methods to be more suitable for children and young people, potentially missing opportunities to more meaningfully engage children in concept elicitation work. CONCLUSIONS Research teams should ensure that they are documenting detailed and transparent processes for concept elicitation. Guidelines are currently lacking in the development and reporting of item generation for children, with this being an important area for future research.
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Affiliation(s)
- Samantha Husbands
- Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK.
| | - Paul Mark Mitchell
- Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK
| | - Joanna Coast
- Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK
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14
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Randa H, Khoury LR, Grønborg TK, Lomholt JJ, Skov L, Zachariae R. Development and preliminary validation of the Adolescent Psoriasis Quality of Life instrument: a disease-specific measure of quality of life in adolescents with psoriasis. Br J Dermatol 2019; 183:96-104. [PMID: 31743420 PMCID: PMC7383696 DOI: 10.1111/bjd.18719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2019] [Indexed: 01/15/2023]
Abstract
Background No age‐appropriate and disease‐specific instrument currently exists to measure health‐related quality of life in adolescents with psoriasis (patients aged 12–17 years). Objectives To develop and provide preliminary validation of the Adolescent Psoriasis Quality of Life instrument. Methods Qualitative interviews with adolescents with psoriasis, parents of adolescents with psoriasis, and healthcare professionals informed the development of an initial item pool for the instrument, which was subsequently refined through cognitive interviews. Finally, data from an independent sample of adolescents with psoriasis (n = 50) were used for item reduction, scale construction and initial validation, using a combination of techniques from classical test theory and Rasch modelling. Results Rich qualitative data concerning health‐related quality of life in adolescents with psoriasis (from 18 adolescents, 14 parents and four healthcare professionals), combined with cognitive interview testing (n = 12), resulted in a 41‐item draft version. Item reduction led to the final version, a 17‐item instrument consisting of two subscales showing good fit to their respective Rasch models: psychosocial impact (12 items) and the impact of physical symptoms and treatment (five items). All a priori stated hypotheses regarding construct validity were supported. Both subscales and the total scale showed acceptable test–retest reliabilities (intraclass correlations 0·97, 0·89 and 0·96) and internal consistencies (Cronbach's α 0·94, 0·81 and 0·95). Conclusions The preliminary form of the Adolescent Psoriasis Quality of Life instrument shows promising psychometric properties. It can be used in daily clinical practice and research to support a patient‐centred approach and inform treatment planning. What's already known about this topic? Health‐related quality of life (HRQoL) instruments should be targeted towards narrowly defined age groups, as life contexts of children, adolescents and adults may differ substantially. Dermatology‐specific instruments have been used to measure HRQoL in adolescents with psoriasis, but it is not known whether these instruments accurately capture all relevant HRQoL aspects in adolescent psoriasis. Age‐appropriate and psoriasis‐specific instruments may be more sensitive for HRQoL issues experienced by this unique group.
What does this study add? The Adolescent Psoriasis Quality of Life instrument represents the first age‐appropriate and disease‐specific instrument for measuring HRQoL in adolescents (12–17 years old) with psoriasis. It is intended for use in daily clinical practice to support dermatologists and other healthcare professionals in providing optimal care for adolescents with psoriasis.
Linked Comment: Blome. Br J Dermatol 2020; 183:9.
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Affiliation(s)
- H Randa
- Unit of Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus C, Denmark.,Department of Psychology and Behavioural Science, Aarhus University, Aarhus C, Denmark
| | - L R Khoury
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - T K Grønborg
- Research Unit for Biostatistics, Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - J J Lomholt
- Department of Psychology and Behavioural Science, Aarhus University, Aarhus C, Denmark
| | - L Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - R Zachariae
- Unit of Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus C, Denmark.,Department of Psychology and Behavioural Science, Aarhus University, Aarhus C, Denmark
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15
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Chernyshov PV. The Evolution of Quality of Life Assessment and Use in Dermatology. Dermatology 2019; 235:167-174. [PMID: 30928986 DOI: 10.1159/000496923] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/15/2019] [Indexed: 11/19/2022] Open
Abstract
The creation of the Dermatology Life Quality Index (DLQI) questionnaire facilitated many studies on the impact of skin diseases on patients' quality of life (QoL). Many national and international guidelines recommend QoL assessment in dermatology, and some of them contain detailed recommendations on treatment goals and changes of treatment approaches based on DLQI score banding and minimal clinically important difference. The methodology of QoL in strument development and validation is constantly becoming more rigorous. Initiatives on selection of core outcome sets for skin diseases are focused on clinical trials but may also be beneficial for clinicians. There are various benefits of using QoL information in clinical practice, but experience of this is very limited at the moment. QoL assessment in dermatology is a rapidly developing field with a gradual shift from theory to practice.
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Affiliation(s)
- Pavel V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine,
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16
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De Vere Hunt I, Chapman K, Wali G, Bullus S, Fisher R, Matin RN, McPherson T. Establishing and developing a Teenage and Young Adult dermatology clinic with embedded specialist psychological support. Clin Exp Dermatol 2019; 44:893-896. [DOI: 10.1111/ced.13950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2019] [Indexed: 10/27/2022]
Affiliation(s)
- I. De Vere Hunt
- Department of Dermatology Oxford University Hospitals NHS Foundation Trust Oxford Oxfordshire UK
| | - K. Chapman
- Department of Dermatology Oxford University Hospitals NHS Foundation Trust Oxford Oxfordshire UK
| | - G. Wali
- Department of Dermatology Oxford University Hospitals NHS Foundation Trust Oxford Oxfordshire UK
| | - S. Bullus
- Department of Dermatology Oxford University Hospitals NHS Foundation Trust Oxford Oxfordshire UK
| | - R. Fisher
- Department of Dermatology Oxford University Hospitals NHS Foundation Trust Oxford Oxfordshire UK
| | - R. N. Matin
- Department of Dermatology Oxford University Hospitals NHS Foundation Trust Oxford Oxfordshire UK
| | - T. McPherson
- Department of Dermatology Oxford University Hospitals NHS Foundation Trust Oxford Oxfordshire UK
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17
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Balieva F. Psoriasis has a huge impact on teenagers. Br J Dermatol 2018; 178:1243. [DOI: 10.1111/bjd.16652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F. Balieva
- Department of Dermatology; Stavanger University Hospital; Pb. 8100 4068 Stavanger Norway
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18
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Prinsen CAC. T-QoL: a quality of life outcome measure specifically developed for adolescents with skin diseases. Br J Dermatol 2018; 178:23-25. [PMID: 29357603 DOI: 10.1111/bjd.16076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C A C Prinsen
- VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands
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