Department of Dermatology, Center for Chronic Pruritus, University Hospital Münster, Münster, Germany.
Comprehensive Wound Center, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
J Eur Acad Dermatol Venereol. 2018 Oct;32(10):1754-1760. doi: 10.1111/jdv.15040. Epub 2018 Jun 7.
Currently available tools to monitor patients with chronic prurigo over time focus on pruritus and quality of life parameters, while no instrument objectively assessing the pruriginous lesions is yet available.
The objective of this study was to develop a physician-assessed Prurigo Activity Score (PAS), a new tool to monitor the distribution and activity of chronic prurigo lesions and to evaluate its reliability and validity.
The 7-item PAS questionnaire as well as validated pruritus intensity scales (VAS, NRS) and a skin-related quality of life score (DLQI) were completed for 264 patients (172 females, age 61 years) at least twice over a period of 2 years. In addition, a 60-min test-retest reliability test was performed by four experts for a random sample of 12 patients.
The PAS showed good test-retest reliability (Cohens κ > 0.61; Cronbach-alpha > 0.76), ordinal or metric items showed high inter-rater reliability (Kendalls > 0.61) and items recording the number of lesions correlated significantly to each other (P < 0.001). The highest correlation to external constructs was achieved with DLQI. The feasibility test conducted by four raters indicated the suitability of PAS for tracking chronic prurigo in the clinical setting.
The PAS is a useful tool to objectively monitor pruriginous lesions in chronic prurigo patients over time. The sensitivity of change in the PAS score should be analysed in future studies.
目前用于监测慢性瘙痒症患者的工具主要集中在瘙痒和生活质量参数上，而尚未有仪器可客观评估瘙痒性病变。
本研究旨在开发一种医生评估的瘙痒症活动评分（PAS），这是一种新的监测慢性瘙痒症病变分布和活动的工具，并评估其可靠性和有效性。
在至少 2 年内，264 名患者（172 名女性，年龄 61 岁）至少两次完成了 7 项 PAS 问卷以及经过验证的瘙痒强度量表（VAS、NRS）和皮肤相关生活质量评分（DLQI）。此外，还对 12 名随机患者进行了 60 分钟的专家测试-重测可靠性测试。
PAS 具有良好的测试-重测可靠性（Cohens κ > 0.61；Cronbach-α > 0.76），有序或度量项目具有较高的评分者间可靠性（Kendalls > 0.61），记录病变数量的项目彼此之间存在显著相关性（P < 0.001）。与外部结构的相关性最高的是 DLQI。四名评分者进行的可行性测试表明，PAS 适合在临床环境中跟踪慢性瘙痒症。
PAS 是一种有用的工具，可用于客观监测慢性瘙痒症患者的瘙痒性病变随时间的变化。未来的研究应分析 PAS 评分变化的敏感性。
