Croce Emily A, Rathouz Paul J, Lopes Fabiana C P S, Leszczynska Maria, Diaz Lucia Z, Levy Moise L, Ruth Jennifer S, Varshney Pooja, Rew Lynn, Matsui Elizabeth C
Dell Children's Medical Group, Ascension Seton, Austin, Texas, USA.
The University of Texas at Austin School of Nursing, Austin, Texas, USA.
Pediatr Dermatol. 2022 Jul;39(4):547-552. doi: 10.1111/pde.15003. Epub 2022 May 6.
BACKGROUND/OBJECTIVES: We sought to quantify the reliability and validity of remote atopic dermatitis (AD) severity assessment using the Eczema Area and Severity Index (EASI) applied to caregiver-provided photos (p-EASI) and videos (v-EASI).
Children (0-17 years) with a physician diagnosis of AD were recruited. Caregivers took photos and a video of their child's skin. A clinician scored in-person EASI on the same day, then p-EASI and v-EASI for each participant 10 days or more between ratings. Two additional clinicians scored p-EASI and v-EASI. Lin's concordance correlation coefficient (CCC) was employed to assess criterion validity using in-person EASI as the gold standard. Intraclass correlation coefficients (ICCs) were calculated to assess interrater reliability of p-EASI and v-EASI.
Fifty racially and ethnically diverse children (age [mean ± SD]: 4.3 ± 4.4 years; 42% female) with a range of AD severity (EASI: 6.3 ± 6.4) and Fitzpatrick skin types (1-2: 9%; 3-4: 60%; 5-6: 31%) were enrolled and received in-person EASI assessment. Fifty had p-EASI and 49 had v-EASI by the same in-person rater, and by two additional raters. The CCC and ICC for p-EASI were 0.89, 95% CI [0.83, 0.95] and 0.81, 95% CI [0.71, 0.89], respectively. The CCC and ICC for v-EASI were 0.75, 95% CI [0.63, 0.88] and 0.69, 95% CI [0.51, 0.81], respectively.
In this diverse population with a range of skin tones, p-EASI showed good criterion validity and good interrater reliability. v-EASI showed moderate to good criterion validity and moderate interrater reliability. Both may be reliable and valid options for remote AD severity assessment.
背景/目的：我们试图量化使用湿疹面积和严重程度指数（EASI）对照顾者提供的照片（p-EASI）和视频（v-EASI）进行远程特应性皮炎（AD）严重程度评估的可靠性和有效性。
招募经医生诊断为AD的儿童（0 - 17岁）。照顾者拍摄其孩子皮肤的照片和视频。一名临床医生在同一天对当面检查的EASI进行评分，然后在至少间隔10天或更长时间后对每位参与者的p-EASI和v-EASI进行评分。另外两名临床医生对p-EASI和v-EASI进行评分。使用当面检查的EASI作为金标准，采用林氏一致性相关系数（CCC）评估标准效度。计算组内相关系数（ICC）以评估p-EASI和v-EASI的评分者间信度。
纳入了50名种族和民族多样的儿童（年龄[均值±标准差]：4.3±4.4岁；42%为女性），其AD严重程度范围较广（EASI：6.3±6.4），Fitzpatrick皮肤类型各异（1 - 2型：9%；3 - 4型：60%；5 - 6型：31%），并接受了当面检查的EASI评估。50名儿童有p-EASI评分，49名有v-EASI评分，均由同一名当面检查的评分者以及另外两名评分者进行。p-EASI的CCC和ICC分别为0.89，95%置信区间[0.83, 0.95]和0.81，95%置信区间[0.71, 0.89]。v-EASI的CCC和ICC分别为0.75，95%置信区间[0.63, 0.88]和0.69，95%置信区间[0.51, 0.81]。
在这个具有多种肤色的多样化人群中，p-EASI显示出良好的标准效度和良好的评分者间信度。v-EASI显示出中等至良好的标准效度和中等的评分者间信度。两者都可能是用于远程AD严重程度评估的可靠且有效的选择。
