Outcome measures of disease severity in atopic eczema.

Abstract

ACCURATE AND appropriate measurements of health outcome form the basis of good evidence-based practice. Methods of assessing the effects of health care intervention are continually being sought, both for use in clinical trials and medical audit, and for guiding the allocation of health service resources.¹ Assessing disease severity in dermatological disorders can present problems because laboratory tests of disease severity often do not exist. In chronic inflammatory dermatological conditions such as atopic eczema, subjective criteria such as itching and sleep disturbance may be the most useful indicators of disease severity and patient morbidity. Other measures such as quality of life measurements, which assess social well-being in addition to personal health status, are being increasingly recognized as important outcome measures, but at present they are largely used to supplement existing measurement tools in dermatology.² In addition to these patient-assessed outcome measures, objective clinical scoring of disease severity for features such as erythema, exudation, and excoriations may provide important additional information that is less subject to social or cultural factors. Such objective clinical scoring forms the basis of many existing severity scales in atopic eczema.