Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland,
Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland.
Dermatology. 2020;236(1):8-14. doi: 10.1159/000501771. Epub 2019 Sep 5.
A wide variety of assessment tools have been proposed for hidradenitis suppurativa (HS) until now, but none of them meets the criteria for an ideal score. Because there is no gold standard scoring system, the choice of the measure instrument depends on the purpose of use and even on the physician's experience in the subject of HS. The aim of this study was to assess the intrarater and interrater reliability of 6 scoring systems commonly used for grading severity of HS: the Hurley Staging System, the Refined Hurley Staging, the Hidradenitis Suppurativa Severity Score System (IHS4), the Hidradenitis Suppurativa Severity Index (HSSI), the Sartorius Hidradenitis Suppurativa Score and the Hidradenitis Suppurativa Physician's Global Assessment Scale (HS-PGA). On the scoring day, 9 HS patients underwent a physical examination and disease severity assessment by a group of 16 dermatology residents using all evaluated instruments. Then, intrarater reliability was calculated using intraclass correlation coefficient (ICC), and interrater variability was evaluated using the coefficient of variation (CV). In all 6 scorings the ICCs were >0.75, indicating high intrarater reliability of all presented scales. The study has also demonstrated moderate agreement between raters in most of the evaluated measure instruments. The most reproducible methods, according to CVs, seem to be the Hurley staging, IHS4, and HSSI. None of the 6 evaluated scoring systems showed a significant advantage over the other when comparing ICCs, and all the instruments seem to be very reliable methods. The interrater reliability was usually good, but the most repeatable results between researchers were obtained for the easiest scales, including Hurley scoring, IHS4 and HSSI.
到目前为止,已经提出了各种各样的评估工具来评估化脓性汗腺炎(HS),但没有一种符合理想评分标准。由于没有黄金标准评分系统,因此测量工具的选择取决于使用目的,甚至取决于医生在 HS 领域的经验。本研究旨在评估 6 种常用于分级 HS 严重程度的评分系统的内部和外部可靠性:Hurley 分期系统、改良 Hurley 分期、化脓性汗腺炎严重程度评分系统(IHS4)、化脓性汗腺炎严重程度指数(HSSI)、Sartorius 化脓性汗腺炎评分和化脓性汗腺炎医生整体评估量表(HS-PGA)。在评分日,9 名 HS 患者接受了一组 16 名皮肤科住院医师的体格检查和疾病严重程度评估,使用了所有评估仪器。然后,使用组内相关系数(ICC)计算内部可靠性,使用变异系数(CV)评估组间变异性。在所有 6 种评分中,ICC 均>0.75,表明所有呈现的量表均具有较高的内部可靠性。该研究还表明,在大多数评估的测量工具中,评分者之间具有中等程度的一致性。根据 CV,最具可重复性的方法似乎是 Hurley 分期、IHS4 和 HSSI。在比较 ICC 时,6 种评估的评分系统均未显示出明显优于其他系统的优势,所有这些仪器似乎都是非常可靠的方法。外部可靠性通常较好,但在研究人员之间获得的最可重复的结果是最容易的量表,包括 Hurley 评分、IHS4 和 HSSI。
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