The Patient‐Oriented Scoring of Atopic Dermatitis and SCORAD in young children: New data on interpretability and clinical usefulness

Abstract

AbstractBackgroundThere is limited data about the clinical meaningfulness of the Scoring of Atopic Dermatitis (SCORAD) and Patient‐Oriented SCORAD (PO‐SCORAD), particularly in children with mild‐to‐moderate AD. Regular use of patient‐reported outcomes, may deliver more accurate information about the overall health status of AD patients than routine but sparse physician assessments.ObjectiveTo confirm the correlation between SCORAD, PO‐SCORAD, Patient‐Oriented Eczema Measure (POEM) and Investigator's Global Assessment (IGA). To evaluate the interpretability and clinical usefulness of the SCORAD and PO‐SCORAD scores in children.MethodsData were drawn from a 12‐week randomized controlled trial in 335 children, aged 2–6 years, with mainly mild‐to‐moderate AD. Investigators captured SCORAD and IGA at each study visit. Parents used PO‐SCORAD twice‐weekly, and POEM once‐weekly.ResultsThere were strong correlations between PO‐SCORAD and SCORAD (r = 0.874), PO‐SCORAD and POEM (0.734) and PO‐SCORAD and IGA (0.613). The best fit (‘k’ statistic: 0.68) between SCORAD and IGA classes was noted for the following SCORAD categories: <12 (clear/almost clear); 12–25 (mild); and ≥25 (moderate/severe). PO‐SCORAD area under the curve over 8 weeks was significantly greater than that of SCORAD (p = 0.0002), giving a better estimate of disease severity between visits. Patients with a flare within the next 7 days had significantly higher PO‐SCORAD scores 7 days before the flare (p < 0.0001). Moderate erythema was the most significant flare predictor (p < 0.0001).ConclusionPO‐SCORAD is robust and reliable and appears to warrant far greater utility in routine clinical practice than other scores. PO‐SCORAD, used twice‐weekly, may improve the management of patients with AD.