Department of Occupational Dermatology, Dermatology clinic, Heidelberg University Hospital, Heidelberg, Germany.
Institute of Social Medicine and Health Systems Research, Otto von Guericke University Magdeburg, Magdeburg, Germany.
Acta Derm Venereol. 2023 Mar 9;103:adv00884. doi: 10.2340/actadv.v103.5383.
Self-assessment of general health status has a significant influence on patient-related outcomes. The aims of this study were to investigate and compare the level of agreement between patients' and dermatologists' assessments of the severity of chronic hand eczema. From the German registry "German Chronic Hand Eczema Patient Long-Term Management Registry" (CARPE), 1,281 pairs of patients with chronic hand eczema and their dermatologists were included. Of these, 788 pairs served as a comparison 2 years after baseline. Concordance analyses found that complete concordance between patients' and dermatologists' assessments were 16.62% at baseline and 11.47% at follow-up. Overall, patients assessed their chronic eczema at baseline as more severe than did the dermatologists; whereas, at follow-up, patients assessed their condition as less severe than the dermatologists' assessment. Bangdiwala's B showed lower values of concordance for womens' and older patients' self-assessment with the dermatologists' assessments. In conclusion, dermatologists should consider the patient's perspective and the individual's assessment of their chronic hand eczema in order to provide effective care in clinical practice.
自我评估总体健康状况对患者相关结局有重要影响。本研究旨在调查和比较患者和皮肤科医生评估慢性手部湿疹严重程度的一致性水平。从德国登记处“德国慢性手部湿疹患者长期管理登记处(CARPE)”中,纳入了 1281 对患有慢性手部湿疹的患者及其皮肤科医生。其中,788 对在基线后 2 年进行了比较分析。一致性分析发现,基线时患者和皮肤科医生评估完全一致的比例为 16.62%,随访时为 11.47%。总体而言,患者在基线时自我评估慢性湿疹比皮肤科医生更严重;而在随访时,患者评估自己的病情比皮肤科医生的评估要轻。Bangdiwala 的 B 显示女性和老年患者自我评估与皮肤科医生评估的一致性值较低。总之,皮肤科医生在临床实践中应考虑患者的观点和个体对其慢性手部湿疹的评估,以提供有效的护理。