Dulon M, Skudlik C, Nübling M, John S M, Nienhaus A
Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services, Pappelallee 35/37, 22089 Hamburg, Germany.
Br J Dermatol. 2009 Jan;160(1):137-42. doi: 10.1111/j.1365-2133.2008.08870.x. Epub 2008 Oct 25.
The Osnabrück Hand Eczema Severity Index (OHSI) is a scoring system for the assessment of the severity of hand eczema (HE).
To assess the clinimetric value of the OHSI and to validate the longitudinal responsiveness of the OHSI using the Manuscore as a gold standard.
OHSI and Manuscore scores were compared before and after 3 weeks' inpatient treatment of 62 patients with occupational HE. Correlation coefficients and 95% limits of agreement were calculated and the ability of OHSI to identify severe HE was analysed. The responsiveness of the OHSI in monitoring skin changes over time was evaluated by calculating effect sizes.
High correlation was found between the OHSI and Manuscore at both scoring occasions (around r(s) = 0.77). Differences between both measurements were within the 95% limits of agreement for 94% of patients, with a tendency for the OHSI to underestimate the severity at very low and at very high values compared with the Manuscore. Responsiveness to change was good. Both instruments showed significant improvement between the scoring occasions. Using the OHSI values, the proportion of classification to the correct tertile of score change was 69%. Effect size from untreated to treated was 0.6 for the Manuscore and 1.1 for the OHSI, with higher effect sizes in individuals with severe HE.
Even though the OHSI allows less differentiation than the Manuscore, it shows adequate validity and responsiveness to change. Thus the OHSI is suitable for both monitoring the severity of HE and the effects of treatment.
奥斯纳布吕克手部湿疹严重程度指数（OHSI）是一种用于评估手部湿疹（HE）严重程度的评分系统。
评估OHSI的临床测量价值，并以Manuscore作为金标准验证OHSI的纵向反应性。
对62例职业性手部湿疹患者进行3周住院治疗前后的OHSI和Manuscore评分进行比较。计算相关系数和95%一致性界限，并分析OHSI识别重度手部湿疹的能力。通过计算效应量评估OHSI在监测皮肤随时间变化方面的反应性。
在两次评分时，OHSI与Manuscore之间均发现高度相关性（约r(s)=0.77）。94%的患者两次测量之间的差异在95%一致性界限内，与Manuscore相比，OHSI在极低值和极高值时倾向于低估严重程度。对变化的反应性良好。两种工具在评分时均显示出显著改善。使用OHSI值，正确评分变化三分位数分类的比例为69%。Manuscore从未治疗到治疗的效应量为0.6，OHSI为1.1，重度手部湿疹患者的效应量更高。
尽管OHSI的区分度不如Manuscore，但它显示出足够的有效性和对变化的反应性。因此，OHSI适用于监测手部湿疹的严重程度和治疗效果。
