Pakornphadungsit Kallapan, Harnchoowong Sarawin, Wattanakrai Penpun
Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Clin Cosmet Investig Dermatol. 2023 Nov 3;16:3171-3179. doi: 10.2147/CCID.S427648. eCollection 2023.
Patient self-assessment is a potential tool in clinical practice to obtain subjective information of acne severity also in clinical trials to assess the general population in research and epidemiologic studies. The patient self-evaluation of acne severity has not yet been developed in Thailand.
We aimed to validate an acne severity grading self-assessment suitable for the Thai population.
A pilot study was conducted in 77 volunteers with acne lesions. We developed the Thai Global Evaluation Acne Scale (TGEA) and Thai Global Acne Grading System (TGAGS) by translating and adapting the original version. Patient self-assessment of acne severity was performed in two rounds. A training session about acne was provided to all participants lesions before starting the second round. Reliability between the self-assessment and clinician assessment of acne severity was statistically assessed.
For TGEA, 48.05% participants rated their acne severity corresponded with the clinicians (Cohen's kappa coefficient, kappa = 0.26). After receiving the training, 79.22% subjects responded their acne severity corresponded with the clinicians (kappa = 0.66). For TGAGS, 77.92% patients who answered their acne severity corresponded with the clinicians (kappa = 0.52). After receiving the training, 94.80% participants responded their acne severity corresponded with the clinicians (kappa = 0.89). For raw score of the TGAGS, the intraclass correlation coefficient (ICC) during the self-assessment of acne severity compared to the clinician assessments was 0.54 and it increased to 0.79 after the training.
Due to the almost perfect reliability, we suggested that TGAGS is a reliable subjective self-assessment of acne severity suitable for the Thai population. The training is essential in enhancing the reliability of this instrument. Our study's findings can facilitate clinical practice and research studies.
患者自我评估是临床实践中获取痤疮严重程度主观信息的潜在工具，在临床试验中也可用于评估研究和流行病学研究中的普通人群。泰国尚未开发出痤疮严重程度的患者自我评估方法。
我们旨在验证一种适用于泰国人群的痤疮严重程度分级自我评估方法。
对77名有痤疮皮损的志愿者进行了一项试点研究。我们通过翻译和改编原始版本，开发了泰国痤疮整体评估量表（TGEA）和泰国痤疮整体分级系统（TGAGS）。痤疮严重程度的患者自我评估分两轮进行。在第二轮开始前，为所有有皮损的参与者提供了一次关于痤疮的培训课程。对痤疮严重程度的自我评估与临床医生评估之间的可靠性进行了统计学评估。
对于TGEA，48.05%的参与者对其痤疮严重程度的评分与临床医生的评分一致（科恩kappa系数，kappa = 0.26）。接受培训后，79.22%的受试者表示其痤疮严重程度与临床医生的评分一致（kappa = 0.66）。对于TGAGS，77.92%回答其痤疮严重程度的患者与临床医生的评分一致（kappa =
0.52）。接受培训后，94.80%的参与者表示其痤疮严重程度与临床医生的评分一致（kappa = 0.89）。对于TGAGS的原始评分，痤疮严重程度自我评估与临床医生评估之间的组内相关系数（ICC）为0.54，培训后增至0.79。
由于几乎具有完美的可靠性，我们建议TGAGS是一种适用于泰国人群的可靠的痤疮严重程度主观自我评估方法。培训对于提高该工具的可靠性至关重要。我们研究的结果有助于临床实践和研究。
