Gillespie Jordan, Bash Gina N, Jacobson Michael E, Latour Emile, Simpson Eric L
Oregon Health & Science University, School of Medicine, Portland, OR, USA.
Oregon Health & Science University, Department of Dermatology, Portland, OR, USA.
Br J Dermatol. 2025 Aug 18;193(3):451-457. doi: 10.1093/bjd/ljaf167.
The Harmonising Outcome Measures for Eczema (HOME) initiative has established a core outcome set for atopic dermatitis (AD) clinical trials, including four core outcome domains: clinician-reported signs, patient-reported symptoms, eczema control and quality of life. For eczema control, the Atopic Dermatitis Control Tool (ADCT) and the Recap of Atopic Eczema (RECAP) were chosen through consensus methods as equivalent instruments.
This study aimed to develop equations to map scores between ADCT and RECAP to facilitate inter-measurement comparison and data synthesis.
Patients with AD completed the HOME core outcome set of instruments, including ADCT, RECAP, Dermatology Life Quality Index series, Peak Pruritus Numerical Rating Scale and Patient-Oriented Eczema Measure, during routine clinic visits. Clinicians assessed disease severity using the Investigator Global Assessment x Body Surface Area measure.
Among 50 participants, ADCT and RECAP were strongly correlated (Pearson's correlation coefficient, r = 0.970). Four mapping models were evaluated: simple linear regression (SLR), SLR without intercept, square root transformation (SRT) and SRT without intercept. While the SRT no intercept model had the lowest root mean square error, it produced nonlinear confidence intervals and risked overfitting. The SLR no intercept model, with high predictive accuracy (R2 = 0.971) and interpretability, was selected as the primary approach. Two equations were derived to convert scores between ADCT and RECAP, enabling standardized comparisons.
This study provides two equations for mapping between ADCT and RECAP, strengthening the HOME outcome measurement set and synthesizing the two measures for clinical and research purposes. Validation with larger, independent cohorts is warranted to confirm these findings.
湿疹协调结局测量（HOME）倡议已为特应性皮炎（AD）临床试验建立了核心结局集，包括四个核心结局领域：临床医生报告的体征、患者报告的症状、湿疹控制和生活质量。对于湿疹控制，通过共识方法选择了特应性皮炎控制工具（ADCT）和特应性湿疹回顾（RECAP）作为等效工具。
本研究旨在建立ADCT和RECAP之间分数映射的方程，以促进测量间的比较和数据综合。
AD患者在常规门诊就诊时完成了HOME核心结局集工具，包括ADCT、RECAP、皮肤病生活质量指数系列、瘙痒峰值数字评定量表和患者导向性湿疹测量。临床医生使用研究者整体评估×体表面积测量法评估疾病严重程度。
在50名参与者中，ADCT和RECAP高度相关（Pearson相关系数，r = 0.970）。评估了四种映射模型：简单线性回归（SLR）、无截距的SLR、平方根变换（SRT）和无截距的SRT。虽然无截距的SRT模型具有最低的均方根误差，但它产生了非线性置信区间并存在过拟合风险。具有高预测准确性（R2 = 0.971）和可解释性的无截距SLR模型被选为主要方法。推导了两个方程来转换ADCT和RECAP之间的分数，实现标准化比较。
本研究提供了ADCT和RECAP之间映射的两个方程，加强了HOME结局测量集，并为临床和研究目的综合了这两种测量方法。有必要用更大的独立队列进行验证以证实这些发现。
