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J Am Acad Dermatol. 2018 Sep 19. pii: S0190-9622(18)32598-2. doi: 10.1016/j.jaad.2018.09.017. [Epub ahead of print]

A Provider Global Assessment Quality Measure for Clinical Practice for Inflammatory Skin Disorders.

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Department of Dermatology, New York Medical College, Metropolitan Hospital, New York, New York, USA. Electronic address:
UC Irvine School of Medicine, Irvine, California, USA.
Department of Dermatology, Keck School of Medicine of University of Southern California, Los Angeles, California, USA.
Department of Dermatology and Department of Medicine, Division of Rheumatology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Dermatology and Skin Surgery, Sumter, South Carolina, USA.
Departments of Dermatology and Epidemiology, Biostatistics and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, and Atlanta Veterans Administration Medical Center, Decatur, Georgia, USA.
International Dermatology Outcome Measures (IDEOM), Windsor, Connecticut, USA.
Department of Dermatology, University of Iowa, Iowa City, Iowa, USA.


In our evolving healthcare system, dermatologists are increasingly being asked to prove the value of care they provide to patients with severe skin diseases. Current quality measures for inflammatory dermatoses have limited validity and feasibility. Through collaboration and a modified Delphi process, the International Dermatology Outcome Measures (IDEOM) group and American Academy of Dermatology (AAD) sought to reach consensus on a valid and feasible provider-assessed global disease severity metric to be incorporated into a quality measure for inflammatory dermatoses. To inform the modified Delphi process, a review of the literature was performed, and data was collected on current provider-assessed global disease severity metrics. Following literature review, 36 members of IDEOM and the AAD participated in the modified Delphi process to reach consensus on features of the metric. Psoriasis, atopic dermatitis, and acne achieved overwhelming consensus for inflammatory dermatoses that could be measured in a global disease severity metric. Consensus was also reached on the utilization of a 5-point ordinal scale with descriptors provided through referenced electronic platforms. Expert development of quality measures incorporating this metric and its inclusion in data collection platforms are critical to enabling dermatologists to prove the value of care provided to patients with severe inflammatory dermatoses.


IDEOM; acne; atopic dermatitis; inflammatory dermatoses; psoriasis; quality measure; quality of care


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