University of Wisconsin School of Medicine, Madison, WI, USA.
Br J Dermatol. 2010 Mar;162(3):587-93. doi: 10.1111/j.1365-2133.2009.09586.x. Epub 2009 Dec 1.
Itching is a subjective and multidimensional experience which is difficult to quantify. Most methodologies to assess itching suffer from being unidimensional, for example only measuring intensity without impact on quality of life, or only measuring scratching activity. None has actually been demonstrated to be able to detect change over time, which is essential to using them as an outcome measure of response to an intervention. The 5-D itch scale was developed as a brief but multidimensional questionnaire designed to be useful as an outcome measure in clinical trials. The five dimensions are degree, duration, direction, disability and distribution.
To study the 5-D with respect to validity, reliability and response to change.
The 5-D was administered to 234 individuals with chronic pruritus due to liver disease (n = 63), kidney disease (n = 36), dermatological disorders (n = 56), HIV/AIDS (n = 28) and burn injuries (n = 51). The 5-D was administered at baseline and after a 6-week follow-up period. A subset of 50 untreated patients was retested after 3 days to assess test-retest reliability.
The 5-D score correlated strongly with a visual analogue score: r = 0.727 at baseline (P < 0.0001), r = 0.868 at the 3-day repeat (P < 0.0001), and r = 0.892 at the 6-week follow-up (P < 0.0001). There was no change in mean 5-D score between day 1 and day 3 in untreated individuals (intraclass correlation coefficient = 0.96, P < 0.0001). The 5-D did, however, detect significant changes in pruritus over the 6-week follow-up period (P < 0.0001). Subanalysis of the different patient groups revealed similar response patterns and scores, with the exception of lower total scores for the burn victims due to lower scores on the distribution domain because they itched only at the site of their burn.
The 5-D, therefore, is a reliable, multidimensional measure of itching that has been validated in patients with chronic pruritus to able to detect changes over time. The 5-D should be useful as an outcome measure in clinical trials.
瘙痒是一种主观的多维体验，难以量化。大多数评估瘙痒的方法都存在一维性的问题，例如仅测量强度而不影响生活质量，或者仅测量搔抓活动。没有一种方法实际上能够检测到随时间的变化，这对于将其用作干预反应的结果测量至关重要。5-D 瘙痒量表是一种简短但多维的问卷，旨在作为临床试验中的结果测量工具。这五个维度分别是程度、持续时间、方向、障碍和分布。
研究 5-D 在有效性、可靠性和变化反应方面的表现。
对 234 名患有慢性瘙痒症的个体进行了 5-D 评估，其中包括肝病（n=63）、肾病（n=36）、皮肤病（n=56）、HIV/AIDS（n=28）和烧伤（n=51）。5-D 在基线时和 6 周随访期进行评估。在未经治疗的患者中，有 50 名患者的亚组在 3 天后进行了重复测试，以评估测试-重测的可靠性。
5-D 评分与视觉模拟评分高度相关：基线时 r=0.727（P<0.0001），3 天重复时 r=0.868（P<0.0001），6 周随访时 r=0.892（P<0.0001）。未经治疗的个体在第 1 天和第 3 天之间的 5-D 评分没有变化（组内相关系数=0.96，P<0.0001）。然而，5-D 在 6 周随访期间确实检测到瘙痒的显著变化（P<0.0001）。对不同患者组的亚组分析显示出相似的反应模式和评分，除了烧伤患者的总分较低，因为他们只在烧伤部位瘙痒，这导致了分布域的评分较低。
因此，5-D 是一种可靠的多维瘙痒测量工具，已在慢性瘙痒症患者中得到验证，能够检测随时间的变化。5-D 应该作为临床试验中的结果测量工具是有用的。
