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Togo CCG, Zidório APC, Sá NMD, Dutra ES. Health-related quality of life and clinical severity in people with epidermolysis bullosa - A proposal for assessing nutritional compromise by body mass index (Birmingham Epidermolysis Bullosa Severity Score). NUTR HOSP 2023. [PMID: 38149521 DOI: 10.20960/nh.04827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES epidermolysis bullosa (EB) is a rare genetic disease characterised by skin fragility with blisters and erosions on the skin and/or mucous membranes. People with EB often experience several extracutaneous manifestations, including clinical and health-related quality of life (HRQoL) complications. Herein, we evaluate their HRQoL and clinical severity and propose an objective criterion for estimating nutritional compromise using the Birmingham Epidermolysis Bullosa Severity Score (BEBS) tool. METHODS this series of cases included people with EB, monitored by a multi-professional team. Clinical severity was assessed with the BEBS, using body mass index ranges by age, as an objective proposal, to estimate the degree of nutritional compromise. To assess HRQoL, the Children's Dermatology Life Quality Index (individuals aged 4-16 years) and the Quality of Life Evaluation in Epidermolysis Bullosa - Brazilian Portuguese (individuals 17 years and over) were used. RESULTS of the nine individuals with recessive dystrophic EB (88.9 % female and 12.91 (SD = 11.71) years), the mean total BEBS score was 24.47 (SD = 12.80) points on a scale of 0 to 100 points. Six participants had significant nutritional compromise according to the proposed criteria. Five of the six participants evaluated for HRQoL reported experiencing some impact, with individuals aged 17 and over being more affected and with greater clinical severity. CONCLUSIONS individuals with greater clinical severity of EB experience a more significant impact on their HRQoL. The proposed quantitative criteria for assessing nutritional compromise may help standardise assessments by professionals monitoring the nutritional status of individuals with EB.
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Affiliation(s)
- Camille Cristine Gomes Togo
- Graduate Program in Human Nutrition. Faculdade de Ciências de Saúde. Universidade de Brasília. Campus Universitário Darcy Ribeiro
| | - Ana Paula Caio Zidório
- Clinical Nutrition Unit. Hospital Universitário de Brasília. Faculdade de Ciências de Saúde. Universidade de Brasília. Campus Universitário Darcy Ribeiro
| | - Natan Monsores de Sá
- Graduate Program in Public Health. Faculdade de Ciências de Saúde. Universidade de Brasília. Campus Universitário Darcy Ribeiro
| | - Eliane Said Dutra
- Graduate Program in Human Nutrition. Faculdade de Ciências de Saúde. Universidade de Brasília. Campus Universitário Darcy Ribeiro
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Chernyshov PV, Marron SE, Koumaki D, Pustišek N, Manolache L, Salavastru C, Suru A, Sendrea A, Svyatenko T, Statkevych O, Boffa MJ, Grech SB, Zemskov S, Kuts VV, Lishchynskyi P, Chernyshov AV, Tomas-Aragones L. Responsiveness and Minimal Clinically Important Difference of the Infants and Toddlers Dermatology Quality of Life Questionnaire. Dermatol Ther (Heidelb) 2023; 13:2879-2893. [PMID: 37731087 PMCID: PMC10613170 DOI: 10.1007/s13555-023-01022-x] [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: 07/19/2023] [Accepted: 08/23/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND The Infants and Toddlers Dermatology Quality of Life (InToDermQoL) is the dermatology-specific proxy health-related quality of life (HRQoL) instrument for children from birth to 4 years. The aim of the present study was to confirm the responsiveness and establish minimal clinically important difference (MCID) for the InToDermQoL. METHODS Parents of children with skin diseases were asked to fill in the InToDermQoL at the initial visit (T1) and subsequent consultation (T2). We hypothesized that correlations between change scores of the InToDermQoL and change scores of global assessment of clinical severity by dermatologists and by patients' parents should be above 0.3. The receiver operating characteristic (ROC) curves method was also used for confirmation of responsiveness and determination of MCIDs of the InToDermQoL. The area under the ROC curve (AUC) was used as an indicator of responsiveness. RESULTS Results of 442 patients were included. Correlations between change scores of age-specific versions of the InToDermQoL and change scores of global assessment of clinical severity by dermatologists and by patients' parents were above 0.3 (0.46-0.74). AUCs for age-specific versions of the InToDermQoL were acceptable (above 0.7) or excellent (above 0.8). Estimated MCIDs for the InToDermQoL were as follows: 3 points of total score change for 0-11 months, 5 for 1-2 years and 3 or 4 for 3-4 years version. Estimated MCIDs for the InToDermQoL version for 1-2-year-old children was higher than MCIDs for the 3-4-year-old version despite the higher number of items in the latter. Therefore a MCID of 5 was recommended for both these versions. CONCLUSIONS Responsiveness for all age-specific versions of the InToDermQoL questionnaire was confirmed. MCIDs for the InToDermQoL are proposed as follows: 3-point change of the total score for age version 0-11 months and 5-point for the age versions 1-2 years and 3-4 years.
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Affiliation(s)
- Pavel V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Bulvar Shevchenko, 13, Kiev, 01601, Ukraine.
| | - Servando E Marron
- Department of Dermatology, Aragon Psychodermatology Research Group (GAI+PD), University Hospital Miguel Servet, Zaragoza, Spain
| | - Dimitra Koumaki
- Department of Dermatology and Venereology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | | | | | - Carmen Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Alina Suru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Adelina Sendrea
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Tetiana Svyatenko
- Department of Skin and Venereal Diseases, Dnipro State Medical University, Dnipro, Ukraine
| | - Olha Statkevych
- Department of Skin and Venereal Diseases, Dnipro State Medical University, Dnipro, Ukraine
| | | | | | - Sergii Zemskov
- Department of General Surgery, Bogomolets National Medical University, Kiev, Ukraine
| | - Volodymyr V Kuts
- Department of Information and Computer Technologies, State Organization "National Institute of Phthisiology and Pulmonology Named After F.G. Yanovsky, National Academy of Medical Sciences of Ukraine", Kiev, Ukraine
| | - Pavlo Lishchynskyi
- Ukrainian Scientific and Practical Center of Endocrine Surgery, Transplantation of Endocrine Organs and Tissues of the Ministry of Health of Ukraine, Kiev, Ukraine
| | - Andrii V Chernyshov
- Department of Cellular Radiobiology, State Institution "National Research Center for Radiation Medicine of National Academy of Medical Sciences of Ukraine", Kiev, Ukraine
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Sensitivity to treatment and score bands of the Infants and Toddlers Dermatology Quality of Life questionnaire. JAAD Int 2022; 10:61-67. [PMID: 36688100 PMCID: PMC9850170 DOI: 10.1016/j.jdin.2022.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2022] [Indexed: 11/27/2022] Open
Abstract
Background The Infants and Toddlers Dermatology Quality of Life (InToDermQoL) questionnaire is the first dermatology-specific proxy health related QoL instrument for children from birth to 4 years. Score meaning bands and the sensitivity to successful therapeutic intervention are important to interpret the clinical meaning of an instrument. Objective The aim of the present study was to check the sensitivity to successful therapeutic intervention and establish score bands of the InToDermQoL questionnaire. Methods Parents or grandparents of 424 children with skin diseases from Spain, Malta, Croatia, Romania, Greece, and Ukraine filled in national language versions of the InToDermQoL questionnaire. Disease severity of children with atopic dermatitis was assessed by SCORAD (Scoring atopic dermatitis). Cohen's d was used to assess the responsiveness of the instrument. Results The mean total InToDermQoL scores significantly decreased after treatment. Severity grading of the SCORAD scores gave stratification of the InToDermQoL severity grades based on 95% confidence intervals. Scores below a calculated minimal important difference of 2 corresponded to no effect on patient's health related QoL. Limitations Score banding may be slightly different across patient population and study context. Conclusion All 3 age-specific versions of the InToDermQoL questionnaire showed sensitivity to treatment. Score bands for the InToDermQoL questionnaire have been established.
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Padniewski JJ, Shaver RL, Schultz B, Pearson DR. Patient Quality of Life Improvement in Bullous Disease: A Review of Primary Literature and Considerations for the Clinician. Clin Cosmet Investig Dermatol 2022; 15:27-42. [PMID: 35046687 PMCID: PMC8759990 DOI: 10.2147/ccid.s324331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 12/24/2021] [Indexed: 12/14/2022]
Abstract
Autoimmune and inherited bullous disorders are rare skin diseases that may have a profound negative impact on quality of life (QOL). Common symptoms include pain, pruritus, and scarring, and complications may result in the loss of the ability to perform daily tasks. Diagnosis may have a negative psychological impact, and ongoing management may require a significant allocation of time and resources by both patients and providers. To provide patient-centered care, consideration of these factors is of utmost importance for the dermatologist treating patients with bullous disorders. Herein, we present a review of the primary literature evaluating QOL in autoimmune and inherited bullous disorders, including pemphigus, pemphigoid, epidermolysis bullosa, and Hailey-Hailey disease.
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Affiliation(s)
| | - Rob L Shaver
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Brittney Schultz
- University of Minnesota Medical School, Minneapolis, MN, USA.,Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
| | - David R Pearson
- University of Minnesota Medical School, Minneapolis, MN, USA.,Department of Dermatology, University of Minnesota, Minneapolis, MN, USA
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Chernyshov PV, Finlay AY, Tomas-Aragones L, Poot F, Sampogna F, Marron SE, Zemskov SV, Abeni D, Tzellos T, Szepietowski JC, Zouboulis CC. Quality of Life in Hidradenitis Suppurativa: An Update. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116131. [PMID: 34204126 PMCID: PMC8201351 DOI: 10.3390/ijerph18116131] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 02/06/2023]
Abstract
Knowledge on hidradenitis suppurativa/acne inversa (HS) is rapidly increasing. HS has a profound impact on patients and their family life. Several factors, such as comorbidities, unemployment and HS severity, make this impact even more severe. The most widely used instrument to measure this impact is the dermatology-specific DLQI. We also identified six HS-specific health-related quality of life (HRQoL) instruments. Of them, HIDRAdisk, HSIA, HiSQOL and HSQoL-24 are better validated but there is still lack of experience of its use. Several treatment methods showed positive effect on patients’ HRQoL. Surgery remains a method with a substantial positive effect on HRQoL. Several studies confirming a positive effect of adalimumab on the HRQoL of patients with HS were published during the last three years. Data on the influence of several other biologics on HRQoL of HS patients are controversial or based on studies with a small number of patients.
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Affiliation(s)
- Pavel V. Chernyshov
- Department of Dermatology and Venereology, Bogomolets National Medical University, 01601 Kiev, Ukraine
- Correspondence: ; Tel.: +38-044-234-8660
| | - Andrew Y. Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK;
| | | | - Francoise Poot
- Department of Dermatology, University Hospital Erasme, 1070 Brussels, Belgium;
| | - Francesca Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, 00167 Rome, Italy; (F.S.); (D.A.)
| | - Servando E. Marron
- Aragon Psychodermatology Research Group (GAI + PD), Department of Dermatology, University Hospital Miguel Servet, 50009 Zaragoza, Spain;
| | - Sergey V. Zemskov
- Department of General Surgery, Bogomolets National Medical University, 01601 Kiev, Ukraine;
| | - Damiano Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, 00167 Rome, Italy; (F.S.); (D.A.)
| | - Thrasyvoulos Tzellos
- Department of Dermatology, NLSH University Hospital, 8092 Bodø, Norway;
- European Hidradenitis Suppurativa Foundation e.V., 06847 Dessau, Germany; (J.C.S.); (C.C.Z.)
| | - Jacek C. Szepietowski
- European Hidradenitis Suppurativa Foundation e.V., 06847 Dessau, Germany; (J.C.S.); (C.C.Z.)
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Christos C. Zouboulis
- European Hidradenitis Suppurativa Foundation e.V., 06847 Dessau, Germany; (J.C.S.); (C.C.Z.)
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences, 06847 Dessau, Germany
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