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Pediatr Allergy Immunol. 2018 May;29(3):290-295. doi: 10.1111/pai.12865. Epub 2018 Feb 25.

Reliability and validity of the Atopic Dermatitis Symptom Score (ADSS).

Author information

1
Department of Pediatrics, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea.
2
Department of Pediatrics, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
3
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
4
Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea.
5
Department of Pediatrics, Chung-Ang University Hospital, Seoul, Korea.
6
Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea.
7
Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, Korea.
8
Statistics and Data Center, Samsung Biomedical Research Institute, Seoul, Korea.

Abstract

BACKGROUND:

We have developed the Atopic Dermatitis Symptom Score (ADSS) by which patients or parents can easily assess and record AD symptoms on a daily basis in a smartphone application. The aim of this study was to evaluate the reliability and validity of the ADSS.

METHODS:

We enrolled 307 children and adolescents with AD. Parents or caregivers were asked to record daily symptoms of the patients (itching, sleep disturbance, erythema, dryness, oozing, and edema) using a scale of 0-4. Statistical analyses consisted of the test-retest reliability, concurrent validity, minimal clinically important difference (MCID), responsiveness, floor or ceiling effects, and screening accuracy. Receiver-operating characteristic analyses were conducted to evaluate the ADSS cutoff point for predicting severe AD (SCORing AD [SCORAD] ≥40).

RESULTS:

Test-retest reliability between daytime and night-time ADSS was good (intraclass correlation coefficient, 0.82 [95% CI: 0.70-0.90]). An increase in ADSS was significantly associated with an increase in SCORAD (r = 0.64, P < .0001) (concurrent validity). The MCID was 4.1 points for the ADSS. There was a significant association between changes in ADSS and SCORAD (r = 0.56, P < .0001), indicating good responsiveness. At the optimal ADSS cutoff value of 7.0, sensitivity, specificity, and positive and negative predictive values were 88.4%, 78.6%, 21.1%, and 99.1%, respectively (screening accuracy).

CONCLUSIONS:

The ADSS can be a useful tool for self-assessment of skin symptoms in children with AD.

KEYWORDS:

assessment; atopic dermatitis; reliability; severity; validity

PMID:
29350788
DOI:
10.1111/pai.12865
[Indexed for MEDLINE]

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