Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, H-1093, Budapest, Hungary.
Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, 26 Üllői út, H-1085, Budapest, Hungary.
Br J Dermatol. 2022 Mar;186(3):485-495. doi: 10.1111/bjd.20765. Epub 2021 Nov 24.
Dermatology Life Quality Index (DLQI) and Skindex-16 are among the most commonly used dermatology-specific health-related quality-of-life (HRQoL) instruments. DLQI has two common scoring methods, the original and the DLQI-Relevant (DLQI-R) modification. Head-to-head comparisons of the measurement properties of the DLQI, DLQI-R and Skindex-16 are currently lacking.
We aim to compare the measurement properties of the DLQI, DLQI-R and Skindex-16.
We analysed data from 618 patients with self-reported physician-diagnosed dermatological conditions from a cross-sectional survey carried out in Hungary in early 2020. DLQI, DLQI-R and Skindex-16 were compared in terms of ceiling and floor effects, informativity, convergent validity and known-group validity.
Mean DLQI, DLQI-R and Skindex-16 total scores were 3·76 ± 5·03, 4·11 ± 5·34 and 29·36 ± 26·62, respectively. Among patients with a DLQI/DLQI-R total score of zero, 64% reported problems on Skindex-16. Overall, 23-38% of patients with 'not relevant' responses on DLQI items 3 (shopping/home/gardening), 7 (working/studying), 8 (interpersonal problems) and 9 (sexual difficulties) reported problems on their corresponding Skindex-16 items. Average relative informativity (Shannon's evenness index) was the highest for Skindex-16 (0·85), followed by DLQI-R (0·66) and DLQI (0·54). DLQI, DLQI-R and Skindex-16 demonstrated similar convergent validity. DLQI was able to better discriminate between known groups of patients based on overall skin-related HRQoL impairment, whereas DLQI-R and Skindex-16 performed better with respect to self-perceived health status.
Skindex-16 seems to be more sensitive than DLQI/DLQI-R in capturing mild impairment in HRQoL. Our findings help to provide a fuller understanding of the difference between DLQI, DLQI-R and Skindex-16 and support the informed choice of instrument for clinical and research purposes.
皮肤病生活质量指数（DLQI）和 Skindex-16 是最常用于评估皮肤病相关生活质量（HRQoL）的特定于皮肤病的工具之一。DLQI 有两种常见的评分方法，即原始评分和 DLQI-R 修正评分。目前缺乏 DLQI、DLQI-R 和 Skindex-16 的测量特性的头对头比较。
我们旨在比较 DLQI、DLQI-R 和 Skindex-16 的测量特性。
我们分析了 2020 年初在匈牙利进行的横断面调查中 618 名自我报告有医生诊断的皮肤病患者的数据。比较了 DLQI、DLQI-R 和 Skindex-16 在天花板和地板效应、信息性、收敛有效性和已知组有效性方面的差异。
平均 DLQI、DLQI-R 和 Skindex-16 总分分别为 3.76±5.03、4.11±5.34 和 29.36±26.62。在 DLQI/DLQI-R 总分均为 0 的患者中，64%报告在 Skindex-16 上存在问题。总体而言，23-38%的 DLQI 项目 3（购物/家务/园艺）、7（工作/学习）、8（人际问题）和 9（性困难）回答“不相关”的患者报告在其对应的 Skindex-16 项目上存在问题。信息性的平均相对信息率（Shannon 均匀度指数）最高的是 Skindex-16（0.85），其次是 DLQI-R（0.66）和 DLQI（0.54）。DLQI、DLQI-R 和 Skindex-16 表现出相似的收敛有效性。DLQI 能够更好地根据总体皮肤相关 HRQoL 受损程度来区分已知的患者组，而 DLQI-R 和 Skindex-16 在自我感知健康状况方面表现更好。
Skindex-16 在捕捉 HRQoL 轻度受损方面似乎比 DLQI/DLQI-R 更敏感。我们的发现有助于更全面地了解 DLQI、DLQI-R 和 Skindex-16 之间的差异，并支持在临床和研究目的方面根据需要选择工具。
