Broward Health Dermatology, Fort Lauderdale, Florida.
Department of Dermatology, Pennsylvania State University College of Medicine, Hershey.
JAMA Dermatol. 2022 Aug 1;158(8):900-911. doi: 10.1001/jamadermatol.2022.2260.
Multiple patient-reported outcome measures (PROMs) for health-related quality of life (HRQoL) exist for patients with acne. However, little is known about the content validity and other measurement properties of these PROMs.
To systematically review PROMs for HRQoL in adults or adolescents with acne.
Eligible studies were extracted from PubMed and Embase (OVID).
Full-text articles published in English or Spanish on development, pilot, or validation studies for acne-specific, dermatology-specific, or generic HRQoL PROMs were included. Development studies included original development studies, even if not studied in acne patients per Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) recommendations. If a study included several diagnoses, the majority (ie, over 50%) of patients must have acne or acne-specific subgroup analyses must be available. Abstract and full-text screening was performed by 2 independent reviewers.
Two independent reviewers assessed study quality applying the COSMIN checklist and extracted and analyzed the data. For each distinctive PROM, quality of evidence was graded by measurement property.
PROM properties (target population, domains, recall period, development language), PROM development and pilot studies, content validity (relevance, comprehensiveness, comprehensibility), and remaining measurement properties (structural validity, internal consistency, cross-cultural validity, reliability, measurement error, criterion validity, construct validity, and responsiveness). Quality of evidence was assigned for each measurement property of included PROMs. An overall recommendation level was assigned based on content validity and quality of the evidence of measurement properties.
We identified 54 acne PROM development or validation studies for 10 acne-specific PROMs, 6 dermatology-specific PROMs, and 5 generic PROMs. Few PROMs had studies for responsiveness. The only acne-specific PROMs with sufficient evidence for content validity were the CompAQ and Acne-Q. Based on available evidence, the Acne-Q and CompAQ can be recommended for use in acne clinical studies.
Two PROMs can currently be recommended for use in acne clinical studies: the Acne-Q and CompAQ. Evidence on content validity and other measurement properties were lacking for all PROMs; further research investigating the quality of remaining acne-specific, dermatology-specific, and generic HRQoL PROMs is required to recommend their use.
有多种针对痤疮患者健康相关生活质量(HRQoL)的患者报告结局测量工具(PROM)。然而,对于这些 PROM 的内容效度和其他测量特性知之甚少。
系统综述痤疮患者 HRQoL 的 PROM。
从 PubMed 和 Embase(OVID)中提取符合条件的研究。
纳入了针对痤疮特异性、皮肤病学特异性或通用 HRQoL PROM 的开发、试点或验证研究的全文发表于英文或西班牙文的文章。根据共识基础选择健康测量仪器标准(COSMIN)建议,即使未在痤疮患者中进行研究,也包括原始开发研究。如果一项研究包含多种诊断,则必须有超过 50%的患者患有痤疮或有痤疮特异性亚组分析。两名独立的审查员进行了摘要和全文筛选。
两名独立的审查员应用 COSMIN 清单评估研究质量,并提取和分析数据。对于每个独特的 PROM,根据测量属性对证据质量进行分级。
PROM 属性(目标人群、领域、回忆期、开发语言)、PROM 开发和试点研究、内容效度(相关性、全面性、可理解性)以及其余测量属性(结构效度、内部一致性、跨文化有效性、可靠性、测量误差、标准效度、结构效度和反应性)。为纳入的 PROM 的每个测量属性分配证据质量等级。根据内容效度和测量属性证据质量,给出总体推荐级别。
我们确定了 54 项痤疮 PROM 开发或验证研究,涉及 10 项痤疮特异性 PROM、6 项皮肤病学特异性 PROM 和 5 项通用 PROM。很少有 PROM 有关于反应性的研究。仅有足够证据支持内容效度的两种痤疮特异性 PROM 是 CompAQ 和 Acne-Q。基于现有证据,推荐在痤疮临床研究中使用 Acne-Q 和 CompAQ。
目前有两种 PROM 可推荐用于痤疮临床研究:Acne-Q 和 CompAQ。所有 PROM 的内容效度和其他测量特性的证据都不足;需要进一步研究以确定其余痤疮特异性、皮肤病学特异性和通用 HRQoL PROM 的质量,以推荐其使用。