Silverberg J I, Lei D, Yousaf M, Janmohamed S R, Vakharia P P, Chopra R, Chavda R, Gabriel S, Patel K R, Singam V, Kantor R, Hsu Derek Y
Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Suite 2B-425, 2150 Pennsylvania Avenue, Washington, DC, 20037, USA.
Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA.
Br J Dermatol. 2021 Jan;184(1):87-95. doi: 10.1111/bjd.19159. Epub 2020 Jul 13.
Multiple atopic dermatitis (AD) severity scales exist, with no gold standard for use in clinical practice.
To determine the measurement properties of the Rajka-Langeland score and compare it with other clinician-reported outcomes in adults and children with AD.
We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n = 427).
Rajka-Langeland had good concurrent validity with the Eczema Area and Severity Index (Spearman rho = 0·63), SCORing AD (SCORAD) (rho = 0·61), objective-SCORAD (rho = 0·52) and body surface area (rho = 0·51); good convergent validity with the numeric rating scale average-itch (rho = 0·60) and worst-itch (rho = 0·59), Patient-Oriented Eczema Measure (rho = 0·57), Dermatology Life Quality Index (rho = 0·53), Patient-Reported Outcomes Measurement Information System Itch Questionnaire (rho = 0·35-0·55) in adults and/or children; fair discriminant validity for patient- and physician-reported global AD severity; good responsiveness to change of severity of AD and itch; good reliability; internal consistency; with no floor or ceiling effects. Interpretability bands (3, clear/almost clear; 4-5, mild; 6-7, moderate; 8-9, severe) and minimal clinically important difference (1 point) were established.
The Rajka-Langeland score showed good construct validity, reliability, internal consistency and responsiveness in adults and children with AD.
存在多种特应性皮炎（AD）严重程度量表，临床实践中尚无金标准。
确定拉伊卡 - 兰格兰德评分的测量属性，并将其与其他临床医生报告的成人及儿童AD结局进行比较。
我们基于皮肤科实践进行了一项前瞻性研究，采用问卷调查并由皮肤科医生进行评估（n = 427）。
拉伊卡 - 兰格兰德评分与湿疹面积和严重程度指数（斯皮尔曼相关系数rho = 0·63）、特应性皮炎评分（SCORAD）（rho = 0·61）、客观SCORAD（rho = 0·52）和体表面积（rho = 0·51）具有良好的同时效度；与数字评定量表平均瘙痒程度（rho = 0·60）和最严重瘙痒程度（rho = 0·59）、患者导向性湿疹测量（rho = 0·57）、皮肤病生活质量指数（rho = 0·53）、患者报告结局测量信息系统瘙痒问卷（成人和/或儿童中rho = 0·35 - 0·55）具有良好的聚合效度；对患者和医生报告的AD总体严重程度具有中等判别效度；对AD严重程度和瘙痒程度的变化具有良好的反应性；具有良好的可靠性和内部一致性；无地板效应或天花板效应。建立了解释性区间（3，清晰/几乎清晰；4 - 5，轻度；6 - 7，中度；8 - 9，重度）和最小临床重要差异（1分）。
拉伊卡 - 兰格兰德评分在成人及儿童AD患者中显示出良好的结构效度、可靠性、内部一致性和反应性。
