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Br J Dermatol. 2019 Dec 3. doi: 10.1111/bjd.18780. [Epub ahead of print]

Development and initial testing of a new instrument to measure the experience of eczema control in adults and children: Recap of atopic eczema (RECAP).

Author information

1
Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK.
2
Patient representative, Nottingham, UK.
3
Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
4
Institute of Social Medicine and Health Economics, Otto von Guericke University Magdeburg, Magdeburg, Germany.
5
Patient representative, Brisbane, Australia.
6
Rotherham NHS Foundation Trust, Rotherham, UK.
7
Population Health Science, University of Bristol.
8
St John's Institute of Dermatology and Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK.
9
Department of Dermatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public health, Infection and Immunity, the Netherlands.
10
Centre for Clinical Research, Lund University, Malmö, Sweden.
11
Centre for Clinical Research, Örebro University, Sweden.

Abstract

BACKGROUND:

Eczema control has been identified as an important outcome by key stakeholders in eczema research (including patients, carers, healthcare professionals, and researchers) but no validated instruments for the domain have been identified.

OBJECTIVE:

to develop a measurement instrument to capture a patient's perspective of eczema control that is suitable for use in eczema clinical trials.

METHODS:

Best practice for development of a patient-reported outcome was followed. A mixed-methods approach was used to develop and refine a conceptual framework, generate, refine and select items and to test the distribution and construct validity of the final scale. The mixed-methods approach involved expert panel meetings (including patient representatives, healthcare professionals and methodologists), and data collection using a focus group, cognitive interviews and an online survey with people with eczema/caregivers. Multivariable linear regression was used in the item selection process.

RESULTS:

Fourteen expert panel members co-produced the instrument; with input from people with eczema/caregivers via a focus group (n=6), cognitive interviews (n=13) and an online survey (n=330). The resulting instrument, Recap of atopic eczema (RECAP), is a seven-item questionnaire that captures eczema control via self or caregiver report. The development process aimed to ensure good content validity and feasibility. Initial testing suggested no floor or ceiling effects and good construct validity. Hypothesised correlation with the Patient-Oriented Eczema Measure was confirmed (r(258) = 0.83, p < 0.001).

CONCLUSION:

RECAP has the potential to improve reporting of eczema control in research and clinical practice. Further exploration of measurement properties is required.

KEYWORDS:

atopic dermatitis; atopic eczema; long-term control of eczema; measurement instrument; patient-reported outcome

PMID:
31794074
DOI:
10.1111/bjd.18780

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