Dalgard F, Svensson A, Holm J Ø, Sundby J
Institute of General Practice and Community Medicine, P.B. 1130 Blindern, 0318 Oslo, Norway.
Br J Dermatol. 2003 Oct;149(4):794-800. doi: 10.1046/j.1365-2133.2003.05596.x.
Estimation of skin diseases in the community is challenging because we do not easily have access to the nonhealthcare-seeking population. A potential tool is a questionnaire asking for self-reported skin complaints. Such an instrument has not yet been developed.
To validate a simple instrument assessing skin morbidity in the general adult population, to predict clinical skin morbidity from self-reported skin complaints.
A questionnaire was drawn up in Norwegian and validated against clinical signs in two samples of an urban population, 100 healthcare-seeking adults in a dermatological clinic, and 100 nonhealthcare-seeking adults. A total self-reported score was calculated and validated against severity of clinical signs (no sign, trivial, moderate or severe). The inter-rater agreement was assessed in a small study including 16 patients from a dermatological clinic.
The participation rate was 98%. The sensitivity was 61%, the specificity 69% and the positive predictive value 82% when the caseness criterion was any clinical sign of skin disease. The agreement was good between the two observers for clinical skin morbidity, with kappa = 0.67.
This questionnaire is a simple tool to evaluate skin morbidity in an adult population. The use of self-reported complaints to predict clinical morbidity may be of value in quantifying and exploring skin diseases at the population level. Further studies are needed to improve the instrument. It is our intention to demonstrate the potential usefulness of this questionnaire in a forthcoming population survey in Norway.
在社区中评估皮肤疾病具有挑战性，因为我们难以接触到未寻求医疗服务的人群。一种潜在的工具是询问自我报告皮肤问题的问卷。但这样的工具尚未开发出来。
验证一种评估普通成年人群皮肤发病率的简单工具，根据自我报告的皮肤问题预测临床皮肤发病率。
用挪威语编制了一份问卷，并在城市人口的两个样本中根据临床体征进行验证，一个样本是皮肤科诊所的100名寻求医疗服务的成年人，另一个样本是100名未寻求医疗服务的成年人。计算出自我报告的总分，并根据临床体征的严重程度（无体征、轻微、中度或重度）进行验证。在一项包括16名皮肤科诊所患者的小型研究中评估了观察者间的一致性。
参与率为98%。当病例标准为任何皮肤疾病的临床体征时，敏感性为61%，特异性为69%，阳性预测值为82%。两位观察者在临床皮肤发病率方面的一致性良好，kappa值为0.67。
这份问卷是评估成年人群皮肤发病率的简单工具。利用自我报告的问题来预测临床发病率在量化和探索人群层面的皮肤疾病方面可能具有价值。需要进一步研究以改进该工具。我们打算在挪威即将进行的一项人群调查中展示这份问卷的潜在用途。
