Limits...
Development of outcome measures for autoimmune dermatoses.

Gaines E, Werth VP - Arch. Dermatol. Res. (2007)

Bottom Line: Validated outcome measures are essential in monitoring disease severity.As a result, evaluation of disease severity and patients' response to therapy over time is less reliable.Ultimately, patient care is compromised.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA.

ABSTRACT
Validated outcome measures are essential in monitoring disease severity. Specifically in dermatology, which relies heavily on the clinical evaluation of the patient and not on laboratory values and radiographic tests, outcome measures help standardize patient care. Validated cutaneous scoring systems, much like standardized laboratory values, facilitate disease management and follow therapeutic response. Several cutaneous autoimmune dermatoses, specifically cutaneous lupus erythematosus (CLE), dermatomyositis (DM), and pemphigus vulgaris (PV), lack such outcome measures. As a result, evaluation of disease severity and patients' response to therapy over time is less reliable. Ultimately, patient care is compromised. These diseases, which are often chronic and relapsing and remitting, are also often refractory to treatment. Without outcome measures, new therapies cannot be systematically assessed in these diseases. Clinical trials that are completed without standardized outcome measures produce less reliable results. Therefore, the development of validated outcome measures in these autoimmune dermatoses is critical. However, the process of developing these tools is as important, if not more so, than their availability. This review examines the steps that should be considered when developing outcome measures, while further examining their importance in clinical practice and trials. Finally, this review more closely looks at CLE, DM, and PV and addresses the recent and ongoing progress that has been made in the development of their outcome measures.

Show MeSH

Related in: MedlinePlus

Cutaneous LE disease area and severity index (CLASI)
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2117335&req=5

Fig1: Cutaneous LE disease area and severity index (CLASI)

Mentions: The CLASI, developed by Albrecht and Werth [2], consists of an activity and damage score (Fig. 1). The activity score takes into account erythema (0–3), scale/hypertrophy (0–2), mucous membrane lesions (0–1), recent hair loss (0–1) and non-scarring alopecia (0–3). The damage score represents dyspigmentation (0–1), scarring/atrophy/panniculitis (0–2), and scarring of the scalp (0–6). Patients are asked if their dyspigmentation lasts 12 months or longer, in which case, the dyspigmentation score is doubled. Each of the above parameters is measured in 13 different anatomical locations, included specifically because they are most often involved in CLE. The most severe lesion in each area is measured.Fig. 1


Development of outcome measures for autoimmune dermatoses.

Gaines E, Werth VP - Arch. Dermatol. Res. (2007)

Cutaneous LE disease area and severity index (CLASI)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2117335&req=5

Fig1: Cutaneous LE disease area and severity index (CLASI)
Mentions: The CLASI, developed by Albrecht and Werth [2], consists of an activity and damage score (Fig. 1). The activity score takes into account erythema (0–3), scale/hypertrophy (0–2), mucous membrane lesions (0–1), recent hair loss (0–1) and non-scarring alopecia (0–3). The damage score represents dyspigmentation (0–1), scarring/atrophy/panniculitis (0–2), and scarring of the scalp (0–6). Patients are asked if their dyspigmentation lasts 12 months or longer, in which case, the dyspigmentation score is doubled. Each of the above parameters is measured in 13 different anatomical locations, included specifically because they are most often involved in CLE. The most severe lesion in each area is measured.Fig. 1

Bottom Line: Validated outcome measures are essential in monitoring disease severity.As a result, evaluation of disease severity and patients' response to therapy over time is less reliable.Ultimately, patient care is compromised.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA.

ABSTRACT
Validated outcome measures are essential in monitoring disease severity. Specifically in dermatology, which relies heavily on the clinical evaluation of the patient and not on laboratory values and radiographic tests, outcome measures help standardize patient care. Validated cutaneous scoring systems, much like standardized laboratory values, facilitate disease management and follow therapeutic response. Several cutaneous autoimmune dermatoses, specifically cutaneous lupus erythematosus (CLE), dermatomyositis (DM), and pemphigus vulgaris (PV), lack such outcome measures. As a result, evaluation of disease severity and patients' response to therapy over time is less reliable. Ultimately, patient care is compromised. These diseases, which are often chronic and relapsing and remitting, are also often refractory to treatment. Without outcome measures, new therapies cannot be systematically assessed in these diseases. Clinical trials that are completed without standardized outcome measures produce less reliable results. Therefore, the development of validated outcome measures in these autoimmune dermatoses is critical. However, the process of developing these tools is as important, if not more so, than their availability. This review examines the steps that should be considered when developing outcome measures, while further examining their importance in clinical practice and trials. Finally, this review more closely looks at CLE, DM, and PV and addresses the recent and ongoing progress that has been made in the development of their outcome measures.

Show MeSH
Related in: MedlinePlus