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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Atopic dermatitis &#40;AD&#41; is a common chronic inflammatory skin disease&#44; affecting 15&#46;5&#37; of children<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">1</span></a> and 7&#46;2&#37; of adults in Spain&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">2</span></a> It is characterised by intense pruritus and recurrent eczematous lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">3</span></a> AD presents symptoms that may lead to interference in daily activities&#44; sleep disturbances&#44; skin pain&#44; impairment of psychosocial and work functioning&#44; and impact on health-related quality of life &#40;HRQoL&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">4&#44;5</span></a> causing a significant burden on patient&#39;s life&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Unlike other disorders&#44; for most dermatological diseases no objective marker of the disease progression is available&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">7</span></a> Consequently&#44; different clinician-reported outcome &#40;ClinRO&#41; measures have been developed to assess clinical signs&#44; and their severity and extent in AD&#44; e&#46;g&#46; Eczema Area and Severity Index &#40;EASI&#41;&#44; Investigator Global Assessment &#40;IGA&#41;&#44; validated IGA for AD &#40;vIGA-AD&#8482;&#41;&#44; SCORing Atopic Dermatitis &#40;SCORAD&#41;&#46; The latter also includes patient&#39;s perspective by evaluating the main symptoms of AD &#40;i&#46;e&#46; pruritus and sleep disturbances&#41;&#46; Assessing symptoms and their impact on daily activities&#44; work productivity&#47;functioning and HRQoL from patient&#39;s perspective is crucial to obtain a holistic view of the impact of the disease and determine its real burden&#46;<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">5&#44;7</span></a> Therefore&#44; patient-reported outcomes &#40;PROs&#41; are an essential complement to ClinRO in AD&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">5</span></a> For this reason&#44; several patient-reported outcome measures &#40;PROMs&#41; have been developed during the last decades and most recently integrated in the development and evaluation of new treatments for AD&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">PROMs are also an integral part of clinical trial programmes in AD&#46; In recent years&#44; a global initiative has appeared to Harmonize Outcome Measures for Eczema &#40;HOME&#41;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">8</span></a> in clinical trials&#46; This initiative has defined a core outcomes set and instruments including&#44; among others&#58; EASI&#44; to measure the signs of the disease&#59; the Patient-Oriented Eczema Measure &#40;POEM&#41;&#44; to collect patient-reported symptoms&#59; Numerical Rating Scale &#40;NRS&#41;&#44; for measuring the peak pruritus over the past 24<span class="elsevierStyleHsp" style=""></span>h&#59; and Dermatology Life Quality Index &#40;DLQI&#41;&#44; to assess HRQoL&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">8</span></a> HOME is currently working on defining a list of suitable instruments for measuring health domains in clinical practice&#44; where 5 domains have been agreed as the principal ones&#58; PRO&#44; disease&#47;flare control&#44; patient global assessment&#44; clinician-reported signs&#44; and eczema specific QoL&#46; POEM&#44; the Patient-oriented SCORAD index &#40;PO-SCORAD&#41;&#44; or both have been selected so far for measuring AD symptoms in clinical practice&#46; Additionally&#44; pruritus NRS has been provisionally recommended as an instrument for measuring pruritus intensity&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Many different PROMs are available to assess PROs in AD in clinical practice&#44; most of which focus on the symptoms and HRQoL impairment&#44; but none comprehensively assesses all aspects of the disease&#46; Due to this variety of instruments&#44; several international reviews of PROMs for AD are available in the literature&#44;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">9&#8211;11</span></a> but to date&#44; none has reviewed the instruments used in Spain for AD&#46; We conducted a systematic review to identify and describe specific PROMs used in AD studies conducted under real-world conditions during the last decade in Spain&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We conducted a systematic review of the literature to identify studies that validated and&#47;or used PROMs for AD in the context of clinical practice in Spain&#46; Spanish &#40;MEDES&#44; IBECS&#41; and international &#40;PubMed&#47;MEDLINE&#41; databases were searched&#46; This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses &#40;PRISMA&#41; recommendations&#44;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">12</span></a> and the recommendations set out in the Cochrane Handbook for Systematic Reviews of Interventions&#46;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">13</span></a> Additionally&#44; a broad search in the grey literature&#44; including specific PRO research tools databases &#40;BiblioPRO&#44; PROQOLID&#41;&#44; the Spanish &#40;AEDV&#41; and European &#40;EADV&#41; Dermatology congress websites&#44; and Google&#47;Google Scholar&#44; was performed&#46; Lastly&#44; the reference lists of retrieved articles were reviewed to complement the systematic search&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The search strategy was focused on disease-related terms&#44; PROs and PROMs&#44; and country of interest &#40;Table S1&#44; Appendix additional material&#41;&#46; The search was limited to original articles and congress communications published in English or Spanish&#44; between April 1&#44; 2010 and April 1&#44; 2020&#46; Publications that reported observational and&#47;or epidemiological studies including Spanish patients with AD&#44; describing the validation of PROMs or the use of tools to measure PROs in AD&#44; were selected&#46; Reviews and opinion articles&#44; letters to the director and clinical trials were excluded from the review&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">After removal of duplicates&#44; two independent researchers selected the eligible publications applying the pre-defined inclusion and exclusion criteria&#46; First&#44; researchers screened by title and abstract&#44; discarding publications outside the scope of the review&#46; Full-text publications were subsequently reviewed&#46; Discrepancies during the selection or evaluation process were resolved by consensus with the involvement of a third researcher&#46; Two independent reviewers extracted data from selected publications&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Selected publications were categorised according to the study objectives in&#58; &#8220;use of PROMs&#8221;&#44; &#8220;use and validation of PROMs&#8221; and &#8220;validation of PROMs&#8221;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Data from each study were extracted&#44; including year of publication&#44; study design&#44; setting &#40;national or multinational&#41;&#44; population type &#40;adults and&#47;or children&#41; and size&#44; condition evaluated &#40;AD or dermatological conditions including AD&#41;&#44; PROs evaluated&#44; and PROMs used&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">For each PROM&#44; extracted data included&#58; outcome measure&#44; type &#40;generic&#47;specific&#41;&#44; target population&#44; domains and&#47;or aspects evaluated&#44; number of items&#44; period evaluated&#44; score range&#44; and the reference of the PROM validation or cross-cultural adaptation&#46; Where information was not available from the retrieved publications&#44; other available literature and PROMs developers&#8217; official websites were reviewed&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Data were summarised descriptively with frequencies and percentages&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">To assess the quality of the included observational studies we used the Strengthening the Reporting of Observational Studies in Epidemiology &#40;STROBE&#41; statement&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">14</span></a> The results of STROBE were calculated as the number of the 22 items adequately reported divided by the number of items&#44; expressed as a percentage&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">A total of 227 potentially relevant titles were initially recovered&#44; 17 of which were considered eligible for inclusion&#46; Two additional publications were identified during our search of key reference lists&#59; hence 19 publications were finally included in the review&#46; Of them&#44; 13 reported the use of PROMs&#44;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">2&#44;15&#8211;26</span></a> five reported the use of PROMs and validation of at least one PROM in Spanish population&#44;<a class="elsevierStyleCrossRefs" href="#bib0455"><span class="elsevierStyleSup">27&#8211;31</span></a> and one reported exclusively the validation of a PROM<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">32</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Characteristics of the identified observational studies</span><p id="par0070" class="elsevierStylePara elsevierViewall">The 19 publications included in the review described 17 different observational studies &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; conducted in the last ten years&#46; Most of these studies &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41; were published in the 2018&#8211;2020 period&#46; Sixty-five percent &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41; of the studies had a cross-sectional design&#44;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">2&#44;17&#44;19&#8211;21&#44;24&#44;25&#44;28&#8211;31</span></a> 24&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#41; were retrospective&#44;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">15&#44;16&#44;18&#44;22&#44;23&#44;26&#44;27</span></a> and 12&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41; were prospective&#46;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">15&#44;22&#44;27</span></a> Regarding the geographical scope&#44; 65&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41; were carried out only in Spain&#46;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">15&#44;16&#44;18&#44;19&#44;21&#8211;23&#44;26&#8211;29&#44;31</span></a> Concerning the study population and the condition evaluated&#44; 71&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41; included only adult patients&#44;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">2&#44;16&#8211;18&#44;20&#44;21&#44;23&#8211;26&#44;30&#44;31</span></a> and 82&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41; only patients with AD&#46;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">2&#44;15&#8211;19&#44;22&#8211;29&#44;31&#44;32</span></a> Lastly&#44; regarding the quality of reporting&#44; cross-sectional and prospective studies showed a high percentage of STROBE items adequately reported &#40;77&#8211;100&#37;&#41;&#44; however case series studies reported percentages below 60&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">16&#44;18&#44;23</span></a> STROBE was not evaluated in one study&#44; for which only the abstract was available &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">PROMs identified in the observational studies</span><p id="par0075" class="elsevierStylePara elsevierViewall">The 17 identified observational studies assessed 13 different PROs&#46; The PROs most frequently evaluated were HRQoL&#44; pruritus as a major symptom of AD&#44; and anxiety and depression&#46; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> represents the frequency of evaluation of PROs in the studies included in the review&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">A total of 18 different PROMs were used&#44; with DLQI and Visual Analogue Scales &#40;VAS&#59; three VAS and one PO-SCORAD VAS for pruritus&#44; one VAS and one PO-SCORAD VAS for sleep disturbances&#41; as the most frequently applied to assess HRQoL and the symptoms of the disease&#44; respectively &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#44; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">HRQoL</span><p id="par0085" class="elsevierStylePara elsevierViewall">To evaluate HRQoL&#44; four different PROMs were used in thirteen observational studies&#44; some of them being administered simultaneously in the same study &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#46; Three PROMs were specific HRQoL questionnaires&#58; DLQI<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">15&#8211;18&#44;21&#44;23&#44;25&#44;27&#44;31</span></a> &#40;or its child &#40;cDLQI&#41; and infant &#40;iDLQI&#41; versions&#41;&#44; Atopic Dermatitis Impact Scale &#40;ADIS&#41;<a class="elsevierStyleCrossRefs" href="#bib0415"><span class="elsevierStyleSup">19&#44;28&#44;29</span></a> and ItchyQoL questionnaire&#46;<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">30</span></a> The other PROM identified was a generic HRQoL questionnaire&#58; Short Form-36 &#40;SF-36&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">24</span></a> DLQI&#44; cDLQI and iDLQI are specific questionnaires for dermatological conditions composed of 10 items&#44; which evaluate symptoms&#44; feelings&#44; and problems related to daily activities&#44; leisure&#44; work and school&#44; personal relationships&#44; and treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0485"><span class="elsevierStyleSup">33&#8211;35</span></a> ADIS is a specific questionnaire for AD that can be administered to adults and children&#44; composed of 9 and 8 items&#44; respectively&#44; which assess patient&#39;s feelings and the impact of AD on social activities&#44; leisure activities&#44; and patients&#8217; relationships&#46;<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">28&#44;29</span></a> ItchyQoL is a specific questionnaire for pruritus used in adults&#44; composed of 22 items that evaluate symptoms&#44; function and emotions&#46;<a class="elsevierStyleCrossRefs" href="#bib0470"><span class="elsevierStyleSup">30&#44;36</span></a> Finally&#44; SF-36 is a generic questionnaire for adults&#44; composed of 36 items evaluating physical function&#44; physical role&#44; body pain&#44; general health&#44; vitality&#44; social function&#44; emotional role and mental health&#46; All these PROMs measure the impact of the disease on patients&#8217; HRQoL&#46;<a class="elsevierStyleCrossRefs" href="#bib0505"><span class="elsevierStyleSup">37&#44;38</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Symptoms and disease control</span><p id="par0090" class="elsevierStylePara elsevierViewall">Three symptoms were evaluated in the studies identified&#44; with pruritus being the most frequently assessed &#40;six studies&#41;&#44; followed by sleep disturbances &#40;two studies&#41; and skin pain &#40;one study&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Pruritus was assessed in the studies using a single PROM &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41; or two PROMs &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#46; Four different PROMs were employed&#58; the Itchy Severity Scale &#40;ISS&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">15&#44;21&#44;27</span></a> a VAS&#44;<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">16&#44;22&#44;26</span></a> a Numerical Rating Scale &#40;NRS&#41;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a> and the PO-SCORAD VAS&#46;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a> ISS is a specific tool for pruritus in skin diseases that quantifies the frequency&#44; intensity and extent of pruritus&#44; and its effect on patients&#8217; mood&#44; sexual life and sleep&#44; in adults and children through a 7- and 6-items questionnaire&#44; respectively&#46;<a class="elsevierStyleCrossRefs" href="#bib0455"><span class="elsevierStyleSup">27&#44;39</span></a> The NRS and VAS are generic unidimensional scales administered to adults to evaluate the pruritus intensity&#44; while the PO-SCORAD VAS has been developed and validated also for use in children&#46;<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">34</span></a> To assess the presence of sleep disturbances one study used a generic VAS&#44;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">22</span></a> while another one used three different measures<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a>&#58; PO-SCORAD VAS&#44; question 2 of POEM &#40;&#8220;Over the last week&#44; on how many nights has your sleep been disturbed because of your eczema&#63;&#8221;&#41;&#44; and a modification of question 4 of the Pittsburgh Sleep Quality Index &#40;PSQI&#41; &#40;&#8220;During the past week&#44; how many hours of actual sleep did you get at night&#63;&#8221;&#41;&#46; Finally&#44; the level of skin pain was assessed in adults using a NRS&#46;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">The degree of disease control from the patient perspective was assessed in one study using a questionnaire based on a 6-point Likert scale&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">AD severity from the patient perspective</span><p id="par0105" class="elsevierStylePara elsevierViewall">AD severity from patient perspective was evaluated in the studies with a single PROM &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41; or three PROMs &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#46; The four PROMs identified were&#58; PO-SCORAD&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">2</span></a> POEM&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">2</span></a> Patient Global Assessment &#40;where the patient assessed the disease as mild&#44; moderate or severe&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">2</span></a> and a self-assessment of the severity &#40;clear&#44; almost clear&#44; mild&#44; moderate or severe&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">25</span></a> The PO-SCORAD is a disease-specific tool that can be used in adults and children and comprises 7 items measuring the severity of AD signs &#40;surface area affected by eczema in the last 3 days&#44; dryness of the skin without eczema&#44; evaluation of the severity of the eczema over the last 3 days&#41;&#44; and two Visual Analogue Scales &#40;PO-SCORAD VAS&#41; to assess the intensity of symptoms &#40;pruritus and sleep disturbances&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">40</span></a> POEM is a specific questionnaire designed for use in adult patients with AD&#44; composed of 7 items that assess AD severity by evaluating the frequency of symptoms &#40;dryness&#44; pruritus&#44; flaking&#44; cracking&#44; sleep loss&#44; bleeding&#44; weeping&#41; per week&#46;<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">41</span></a> Although not identified in our review&#44; a children&#39;s version is also available&#46;<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">42</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Treatment satisfaction</span><p id="par0110" class="elsevierStylePara elsevierViewall">Patient satisfaction with maintenance therapy for AD was determined in one study using multiple VAS&#46;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">29</span></a> Different aspects of satisfaction were evaluated&#44; including overall satisfaction&#44; satisfaction with the prevention of flares&#44; satisfaction with lengthening of flare-free intervals&#44; satisfaction with frequency of treatment application&#44; satisfaction with information received about maintenance therapy&#44; and satisfaction with information received about treating flares during maintenance therapy&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Adherence</span><p id="par0115" class="elsevierStylePara elsevierViewall">Two PROMs were used to assess adherence in two studies&#58; the Morisky medication adherence scale&#44;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">29</span></a> a validated generic questionnaire&#44;<a class="elsevierStyleCrossRefs" href="#bib0535"><span class="elsevierStyleSup">43&#44;44</span></a> was used to measure treatment adherence&#44; while a questionnaire based on a 6-point Likert scale<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a> was employed to evaluate adherence to medical recommendations&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Psychosocial impact</span><p id="par0120" class="elsevierStylePara elsevierViewall">The psychosocial impact of AD was evaluated in four studies using a single PROM &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41; or two PROMs &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#46; The presence of anxiety and depression associated to AD was assessed through the Hospital Anxiety and Depression Scale &#40;HADS&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">17&#44;20&#44;21&#44;25</span></a> HADS is a generic questionnaire for adults composed of two subscales&#44; one of them measuring the presence of anxiety &#40;7 items&#41; and the other depression &#40;7 items&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0545"><span class="elsevierStyleSup">45&#44;46</span></a> The Atopic Eczema Score of Emotional Consequences &#40;AESEC&#41;&#44; a specific questionnaire for adults with AD composed of 28 items&#44; was used to determine the effect of AD on the patient emotional status&#46;<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">25</span></a> The psychometric properties of AESEC were reported in detail by Arents et al&#46;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">32</span></a> The Family APGAR&#44; a generic questionnaire for adults composed of 5 items&#44;<a class="elsevierStyleCrossRefs" href="#bib0555"><span class="elsevierStyleSup">47&#44;48</span></a> allowed to assess how family function &#40;adaptation&#44; partnership&#44; growth&#44; affection&#44; and resolve&#41; was affected by AD&#46;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">21</span></a></p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Work productivity and activity impairment</span><p id="par0125" class="elsevierStylePara elsevierViewall">The work productivity &#40;including absenteeism&#44; presenteeism&#44; overall work impairment&#44; and activity impairment&#41; was evaluated in one study using Work Productivity and Activity Impairment &#40;WPAI&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">24</span></a> a generic questionnaire for adults composed of 6 items&#46;<a class="elsevierStyleCrossRefs" href="#bib0565"><span class="elsevierStyleSup">49&#44;50</span></a></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Patient empowerment</span><p id="par0130" class="elsevierStylePara elsevierViewall">The level of patient empowerment was assessed in one study using the Dermatitis AT&#243;pica EMPoderamiento &#40;DATEMP&#41;&#44; a specific questionnaire for adults with AD&#44; originally developed and validated in Spanish&#44; composed of 17 items&#44; which evaluates aspects such as active self-care&#44; basic knowledge about the disease&#44; personal-social concerns&#44; and intention to change&#46;<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">31</span></a></p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0135" class="elsevierStylePara elsevierViewall">This review identified and described PROMs used in observational studies in AD in Spain during the last 10 years to assess key aspects of the disease from the patients&#8217; perspective&#46; The identified PROMs assessed the occurrence of symptoms &#40;e&#46;g&#46;&#44; pruritus&#41; and disease severity&#44; interference with daily activities&#44; impact on psychosocial and work functioning&#44; patient empowerment and HRQoL&#46; This review provides dermatologists an overview of tools available to measure PROs in observational studies with applicability in clinical practice in Spain&#46; The growing interest in measuring PRO outcomes to obtain the patient perspective is reflected in the results of the review&#44; with more than half of the observational studies identified published in the last three years&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">In total&#44; eighteen different PROMs were identified&#58; 55&#37; were generic &#40;applicable to a wide range of conditions&#41;&#44; 6&#37; specific for dermatological conditions &#40;applicable to different skin disorders&#41;&#44; 11&#37; specific for pruritus &#40;one of the main symptoms of AD&#41;&#44; and one third specific for AD&#46; Both specific measures for dermatology and AD provide a complementary view of affected areas&#47;domains that are not assessed with generic instruments&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">The PROMs identified assessed thirteen distinct patient outcomes&#44; where HRQoL&#44; symptoms &#40;mainly pruritus&#41; and anxiety&#47;depression were the most frequently evaluated&#46; These findings are in line with a previous systematic review identifying PROMs used in clinical trials to assess new treatments in AD&#44; where tools to evaluate HRQoL and pruritus&#44; were the most frequently employed&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">5</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Our review shows that DLQI and its children and infant versions are also the most frequently used in observational studies in Spain&#46; Despite not being an AD specific tool&#44; DLQI has been widely used as a HRQoL measure in dermatology clinical trials&#44; validated in AD patients&#44; and included in HOME recommendations from 2017&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">9</span></a> Even though previous studies have shown a significant correlation between HRQoL measures such as DLQI and AD severity&#44; there is scarce information about the routine use of HRQoL measures in the management of patients with AD&#46;<a class="elsevierStyleCrossRef" href="#bib0590"><span class="elsevierStyleSup">54</span></a> This review underlines the widespread use of DLQI in observational studies in dermatology in Spain&#46; Moreover&#44; its inclusion as an outcome suggests that it is feasible to integrate information about the impact of the disease and its symptoms on HRQoL under clinical practice conditions&#46; Measuring tools such as DLQI may help to better assess how well the disease is being managed&#47;controlled and the effectiveness of treatments beyond objective clinical assessment&#46; Nevertheless&#44; DLQI subscales have previously shown a considerable floor effect &#40;which makes it difficult to detect worsening of perceived HRQoL&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0595"><span class="elsevierStyleSup">55</span></a> and last HOME systematic review of HRQoL measures indicated insufficient structural validity for DLQI to be recommended for use&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">11</span></a>Some authors recommend adding a generic to a dermatology-specific PROM&#44; to measure individuals&#8217; health status in generic terms&#44; and in situations where the skin disease has a substantial generic HRQoL impact beyond the disease-specific impact&#46;<a class="elsevierStyleCrossRefs" href="#bib0605"><span class="elsevierStyleSup">57&#44;58</span></a> Our review identified SF-36 as a possible available generic HRQoL tool for Spanish population&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">According to the last HOME consensus&#44;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">6</span></a> patient-reported symptoms is the highest-prioritized domain to measure in clinical practice in patients with atopic eczema&#46; In our review&#44; symptoms were measured as a stand-alone outcome &#40;using VAS or NRS&#41; or together with other aspects of the disease as part of a comprehensive PROM&#44; such as PO-SCORAD&#44; POEM or HRQoL questionnaires&#46; Symptoms&#44; as a stand-alone outcome&#44; were evaluated in a third of the studies reviewed&#46;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">15&#8211;17&#44;21&#44;22&#44;26&#44;27</span></a> Pruritus was assessed in all of them&#44; with pruritus VAS as the most used PROM &#40;67&#37;&#41;&#44; unlike the recommendations of HOME&#44; that provisionally recommend a NRS as preferred tool to measure pruritus intensity&#46; Sleep disturbances were evaluated in one third of the studies assessing patient-reported symptoms as a stand-alone outcome&#44;<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">17&#44;22</span></a> and skin pain in 17&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a> Although they are the major symptoms in AD and a relevant domain for clinical trials&#44; they are not yet seen as a standard measure for clinical practice&#46; In a previous systematic review evaluating symptom reporting in clinical trials in AD&#44; it was found that 78&#37; of them used PROMs to assess symptoms&#44; of which only 37&#37; measured symptoms as stand-alone outcomes&#46; Among them&#44; pruritus was the most assessed symptom &#40;98&#37;&#41;&#44; with VAS being the most used PROM &#40;76&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0600"><span class="elsevierStyleSup">56</span></a> followed by sleep disturbance &#40;61&#37;&#41;&#44; which is largely considered a surrogate of pruritus&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Since in patients with moderate and severe AD the symptomatology can impact on patient&#39;s daily living activities and emotional wellbeing&#44;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">15</span></a> measuring symptoms&#44; especially pruritus&#44; becomes a key point in the evaluation of the disease&#46; Our review has identified both unidimensional &#40;VAS or NRS&#41; and multidimensional tools &#40;PO-SCORAD or POEM&#41; to evaluate pruritus&#46; Although unidimensional scales and PO-SCORAD assess the intensity of itching&#44; and POEM collects its frequency&#44; multidimensional tools provide a more holistic view of the disease&#44; and they have been previously correlated with the severity of AD and different dimensions of HRQoL&#46;<a class="elsevierStyleCrossRef" href="#bib0605"><span class="elsevierStyleSup">57</span></a> However&#44; the use of these instruments in clinical practice is scarce and limited to clinical research&#44; and according to HOME initiative&#44; unidimensional scales are preferred as a simple and rapid method for pruritus intensity assessment in clinical practice&#46;<a class="elsevierStyleCrossRefs" href="#bib0615"><span class="elsevierStyleSup">59&#8211;62</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">Our results show that the AD&#39;s psychosocial impact&#44; including anxiety and depression&#44; emotional consequences and family function are PROs evaluated in recent observational studies identified&#46; Among them&#44; anxiety and depression have been the most assessed PROs and HADS questionnaire the main PROM used&#46; This is in alignment with the high burden of psychiatric-related disorders reported in the literature among patients with AD in Spain e&#46;g&#46; de Bruin-Weller et al&#46; report the presence of emotional or mental comorbidity in 17&#8211;31&#37; of patients with mild to severe AD&#44; respectively&#44; which increases with disease severity&#46;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a> Higher prevalence of anxiety and depression in patients with AD compared to patients without AD has been reported&#44; associating worse HADS scores with worse disease severity&#46;<a class="elsevierStyleCrossRef" href="#bib0635"><span class="elsevierStyleSup">63</span></a> Additionally&#44; Spanish patients experiencing chronic pruritus present statistically significant differences for the anxiety subscale of HADS compared to those who do not experience chronic pruritus&#46;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">21</span></a> Because of the association between AD and psychiatric disorders&#44; HADS could be a useful tool in clinical practice to assess the mental health of these patients&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Recently&#44; an international study in adult patients with AD has evidenced the high impact on patient productivity and activity&#44; with a greater negative impact on patients with moderate and severe disease&#46;<a class="elsevierStyleCrossRef" href="#bib0640"><span class="elsevierStyleSup">64</span></a> Reducing the severity of the AD can be expected to decrease the burden on the patient and therefore the impact on productivity and activity&#44; which could be an aspect to be taken into account to assess in clinical practice&#46; However&#44; current review has identified only one study assessing the impact of AD on work productivity and activity through the WPAI questionnaire&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Finally&#44; in our review&#44; the Morisky medication adherence scale was the PROM chosen to evaluate patient adherence to treatment&#44;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">29</span></a> while a Likert Scale was used to measure adherence to medical recommendations&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a> To assess patient&#39;s satisfaction a VAS was employed&#46;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">29</span></a> These results highlight the possible underestimation of the impact of adherence and patient satisfaction with treatment in AD patients&#44; as only two publications evaluate them&#44; relevant to assess the effectiveness of the prescribed treatment&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Despite the increasing number of studies evaluating PROMs in our review&#44; the systematic use of tools to capture patient perception for a holistic management of AD in Spain is still scarce&#46; The limited use of PROMs in clinical practice could be due to the reduced time in consultations&#44; the lack of collaboration or inability of patients to complete PROMs&#44; the lack of habit in incorporating the patient in decision making&#44; and the current healthcare model where the patient&#39;s empowerment is low&#46; Nevertheless&#44; our results show that the use of PROMs in clinical practice could be increasing since the patient&#39;s perspective is becoming more relevant to the clinician in disease management&#46; There is still scope for increased measurement of patient-reported symptoms and its consequences on different aspects of patient&#39;s life&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">This review&#39;s main strength is the systematic approach used and the focus on PROs assessed in observational studies&#44; which allowed to provide an overview of identified PROMs that may be applicable for use in routine clinical practice conditions&#46; This review is not exempt of limitations&#46; Although STROBE checklist was used to determine the quality of the included observational studies&#44; the review did not analyse the possible biases of the included observational studies&#46; In addition&#44; the review included international studies involving Spanish patients with AD regardless of their sample size&#46; Therefore&#44; their results may not be an accurate representation of our setting&#46; However&#44; the review&#39;s objective was not to analyse the results obtained in those studies but to identify possible PROMs used in real-world studies that may have applicability in clinical practice&#46; Lastly&#44; our review was not designed to be a comprehensive review of all available PROMs but rather to identify PROMs used in real-world studies as these may provide a better reflection of routine clinical practice in Spain&#46; As such&#44; PROMs used in clinical trials and those not reported in observational studies including Spanish patients over the last decade were excluded&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusions</span><p id="par0190" class="elsevierStylePara elsevierViewall">The number of real-world studies that include PROMs conducted in Spanish AD patients has increased over time&#44; suggesting a growing importance of PROs in assessing and managing AD from a patient-centred point of view&#46; Several validated PROMs are available for use in Spain&#44; covering the main aspects of the disease&#44; including symptoms &#40;e&#46;g&#46; pruritus&#41; and disease severity&#44; interference with daily activities&#44; impact on psychosocial and work functioning&#44; patient empowerment and HRQoL&#46; However&#44; there is still scope for increasing the measurement of patient-reported symptoms to understand their consequences and impact on patient&#39;s life in terms of disease progression and treatment effectiveness&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicts of interest</span><p id="par0195" class="elsevierStylePara elsevierViewall">Lilly Spain has financed the publication of this article&#46;</p></span></span>"
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              "titulo" => "Characteristics of the identified observational studies"
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              "titulo" => "PROMs identified in the observational studies"
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              "titulo" => "AD severity from the patient perspective"
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    "fechaRecibido" => "2021-09-27"
    "fechaAceptado" => "2022-01-25"
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            0 => "Atopic dermatitis"
            1 => "Patient-reported outcome measures"
            2 => "Health-related quality of life"
            3 => "Symptoms"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Atopic dermatitis &#40;AD&#41; is a chronic inflammatory skin disease with symptoms such as pruritus that can be a major burden for patients&#46; Patient-reported outcomes &#40;PRO&#41; complement clinician-reported outcomes in AD&#46; This systematic review aims to identify and describe patient-reported outcome measures &#40;PROM&#41; used in observational studies of AD over the last decade in Spain&#46; Eighteen PROM were identified to measure 13 different PRO that assess multiple aspects of the disease&#44; including symptoms and disease severity&#44; impact on daily activities and on work productivity&#47;functioning&#44; psychosocial impact&#44; patient empowerment&#44; and health-related quality of life &#40;HRQoL&#41;&#46; HRQoL&#44; symptoms &#40;particularly pruritus&#41;&#44; and anxiety&#47;depression were the most frequently assessed PRO&#44; and the Dermatology Quality of Life Index&#44; the Visual Analogue Pruritus Scale&#44; and the Hospital Anxiety and Depression Scale were the most frequently used PROM&#44; respectively&#46; The growing number of observational studies on AD including PROM in Spain suggests that PRO are becoming increasingly important in the management of AD&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La dermatitis at&#243;pica &#40;DA&#41; es una enfermedad cut&#225;nea inflamatoria cr&#243;nica con s&#237;ntomas tales como el prurito&#44; que pueden causar una carga significativa en la vida del paciente&#46; Los resultados percibidos por los pacientes &#40;PRO&#41; complementan a los resultados cl&#237;nicos evaluados en la DA por los m&#233;dicos&#46; Esta revisi&#243;n sistem&#225;tica tiene como objetivo identificar y describir las medidas de los resultados percibidos por los pacientes &#40;PROM&#41; utilizadas en estudios observacionales de DA durante la &#250;ltima d&#233;cada en Espa&#241;a&#46; Se identificaron 18 PROM para medir 13 PRO diferentes que eval&#250;an m&#250;ltiples aspectos de la enfermedad&#44; incluyendo los s&#237;ntomas y la gravedad de la enfermedad&#44; la interferencia con las actividades diarias&#44; el impacto psicosocial y laboral&#44; el empoderamiento del paciente y la calidad de vida relacionada con la salud &#40;CVRS&#41;&#46; La CVRS&#44; los s&#237;ntomas &#40;principalmente el prurito&#41; y la ansiedad&#47;depresi&#243;n fueron los PRO m&#225;s evaluados&#44; siendo el <span class="elsevierStyleItalic">Dermatology Life Quality Index</span>&#44; la Escala Visual Anal&#243;gica del prurito y la <span class="elsevierStyleItalic">Hospital Anxiety and Depression Scale</span>&#44; las PROM m&#225;s frecuentemente empleadas&#44; respectivamente&#46; El n&#250;mero creciente de estudios observacionales sobre DA que incluyen PROM en Espa&#241;a sugiere un aumento de la importancia de los PRO en el manejo de la DA&#46;</p></span>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Publication selection flowchart according to PRISMA&#46; MEDES&#58; MEdicina en ESpa&#241;ol&#59; IBECS&#58; &#205;ndice Bibliogr&#225;fico Espa&#241;ol en Ciencias de la Salud&#59; AEDV&#58; Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a&#59; EADV&#58; European Academy of Dermatology and Venereology&#59; PROM&#58; Patient-Reported Outcomes Measure&#46;</p>"
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          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Frequency of PROMs used in the 17 observational studies&#46; ADIS&#58; Atopic Dermatitis Impact Scale&#59; AESEC&#58; Atopic Eczema Score of Emotional Consequences&#59; cDLQI&#58; children Dermatology Life Quality Index&#59; DATEMP&#58; Dermatitis AT&#243;pica EMPoderamiento&#59; DLQI&#58; Dermatology Quality of Life Index&#59; HADS&#58; Hospital Anxiety and Depression Scale&#59; iDLQI&#58; infant Dermatology Life Quality Index&#59; ISS&#58; Itchy Severity Scale&#59; MCS&#58; Mental Component Scale&#59; NRS&#58; Numerical rating ScalePCS&#58; Physical Component Scale&#59; PO-SCORAD&#58; Patient Oriented Scoring Atopic Dermatitis&#59; POEM&#58; Patient-Oriented Eczema Measure&#59; SF-36&#58; Short Form-36&#59; VAS&#58; Visual Analogue Scale&#59; WPAI&#58; Work Productivity and Activity Impairment&#59; &#42;includes VAS for treatment satisfaction &#40;1&#41;&#44; VAS for pruritus &#40;3&#41;&#44; VAS for sleep disturbances &#40;1&#41;&#59; PO-SCORAD VAS for pruritus &#40;1&#41; and PO-SCORAD VAS for sleep disturbances &#40;1&#41;&#59; &#42;&#42;includes a Likert scale for disease control and a Likert scale for treatment adherence&#59; &#42;&#42;&#42;includes NRS for pruritus &#40;1&#41; and NRS for skin pain &#40;1&#41;&#59; <span class="elsevierStyleSup">i</span>One of the studies only evaluated the depression component of the questionnaire &#40;HADS-D&#41;&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Geography&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Population type and size &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Condition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PRO evaluated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PROMs used&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">STROBE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Daud&#233;n et al&#46; &#40;2011&#41;<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">27</span></a>&#44; Sanchez Perez at al&#46; &#40;2013&#41;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">15</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospective</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;172&#41; and children &#40;151&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ISS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#47;2286&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&#44; cDLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Torrelo et al&#46; &#40;2012&#41;<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">28</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;159&#41; and children &#40;163&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADIS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#47;2295&#37; of items well-reported&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Torrelo et al&#46; &#40;2013&#41;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">29</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;141&#41; and children &#40;141&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&#44; cDLQI&#44; iDLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#47;22100&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADIS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Morisky medication adherence scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Satisfaction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ortiz de Frutos et al&#46; &#40;2014&#41;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;125&#41; and children &#40;116&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADIS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#47;2295&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disease control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Likert scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Likert scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dalgard et al&#46; &#40;2015&#41;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">20</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multinational &#40;BE&#44; DK&#44; FR&#44; DE&#44; HU&#44; IT&#44; NL&#44; NO&#44; PL&#44; RU&#44; SP&#44; TR&#44; UK&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Several dermatological conditions including AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anxiety&#47;depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HADS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#47;22100&#37; of items well-reported&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Marron et al&#46; &#40;2016&#41;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">21</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;11&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Several dermatological conditions including AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ISS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#47;2277&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anxiety&#47;depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HADS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Family function&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Family APGAR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Barbarot et al&#46; &#40;2018&#41;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">2</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multinational &#40;FR&#44; DE&#44; IT&#44; SP&#44; UK&#44; USA&#44; CA&#44; JP&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;9924&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disease severity from the patient perspective</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#47;22100&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">POEM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient Global Assessment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ib&#225;&#241;ez et al&#46;&#44; &#40;2018&#41;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">22</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospective</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Children &#40;275&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#47;22100&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sleep disturbances&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Benavente Villegas et al&#46; &#40;2018&#41;<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">23</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospective case series&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#47;2232&#37; of items well-reported&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Zeidler at al&#46; &#40;2018&#41;<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">30</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multinational &#40;FR&#44; DE&#44; IT&#44; PO&#44; RU&#44; SP&#44; CH&#44; TR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Several dermatological conditions including AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ItchyQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#47;2291&#37; of items well reported&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eckert et al&#46; &#40;2019&#41;<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">24</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multinational &#40;FR&#44; DE&#44; IT&#44; SP&#44; UK&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SF-36 &#40;PCS and MCS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#47;2295&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Work productivity and activity impairment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">WPAI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ring et al&#46; &#40;2019&#41;<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">25</span></a>&#44; Arents et al&#46; &#40;2019&#41;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">32</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multinational &#40;FR&#44; SP&#44; IT&#44; UK&#44; DE&#44; NL&#44; DK&#44; SE&#44; CZ&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;180&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disease severity</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">POEM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#47;2286&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Self-assessment of severity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anxiety&#47;depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HADS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Emotional consequences&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AESEC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hernandez-Fernandez et al&#46; &#40;2019&#41;<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">26</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospective case series&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not calculated &#40;only abstract available&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ruiz-Villaverde et al&#46; &#40;2019&#41;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">16</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospective case series</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;30&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#47;2259&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pereyra-Rodriguez et al&#46; &#40;2019&#41;<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">31</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;17&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient Empowerment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DATEMP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#47;2282&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">de Bruin-Weller et al&#46; &#40;2020&#41;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multinational &#40;FR&#44; DE&#44; SP&#44; IT&#44; UK&#44; CA&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;290&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NRS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#47;2286&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NRS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sleep disturbances</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Question 2 of POEM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Question 4 of PSQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anxiety&#47;depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HADS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Brice&#241;o Casado et al&#46; &#40;2020&#41;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">18</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospective case series&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#47;2259&#37; of items well-reported&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">3720 international patients &#40;1860 with AD&#44; 1860 without AD&#41;&#44; 37&#37; of the sample were Spanish patients&#46; BE&#58; Belgium&#59; CA&#58; Canada&#59; CH&#58; Switzerland&#59; CZ&#58; Czech Republic&#59; DE&#58; Germany&#59; DK&#58; Denmark&#59; FR&#58; France&#59; HU&#58; Hungary&#59; IT&#58; Italy&#59; JP&#58; Japan&#59; NL&#58; Netherlands&#59; NO&#58; Norway&#59; PL&#58; Poland&#59; RU&#58; Russia&#59; SE&#58; Sweden&#59; SP&#58; Spain&#59; TR&#58; Turkey&#59; UK&#58; United Kingdom&#59; USA&#58; United States&#59; AD&#58; Atopic dermatitis&#59; ADIS&#58; Atopic Dermatitis Impact Scale&#59; AESEC&#58; Atopic Eczema Score of Emotional Consequences&#59; cDLQI&#58; children Dermatology Life Quality Index&#59; DATEMP&#58; Dermatitis AT&#243;pica EMPoderamiento&#59; DLQI&#58; Dermatology Quality of Life Index&#59; HADS&#58; Hospital Anxiety and Depression Scale&#59; HRQoL&#58; health Related Quality of Life&#59; iDLQI&#58; infant Dermatology Life Quality Index&#59; ISS&#58; Itchy Severity Scale&#59; MCS&#58; Mental Component Scale&#59; NRS&#58; Numerical rating ScalePCS&#58; Physical Component Scale&#59; PO-SCORAD&#58; Patient Oriented Scoring Atopic Dermatitis&#59; POEM&#58; Patient-Oriented Eczema Measure&#59; PSQI&#58; Pittsburgh Sleep Quality IndexSF-36&#58; Short Form-36&#59; VAS&#58; Visual Analogue Scale&#59; WPAI&#58; Work Productivity and Activity Impairment&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the observational studies included in the review&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">ADIS&#58; Atopic Dermatitis Impact Scale&#59; AESEC&#58; Atopic Eczema Score of Emotional Consequences&#59; cDLQI&#58; children Dermatology Life Quality Index&#59; DATEMP&#58; Dermatitis AT&#243;pica EMPoderamiento&#59; DLQI&#58; Dermatology Quality of Life Index&#59; HADS&#58; Hospital Anxiety and Depression Scale&#59; iDLQI&#58; infant Dermatology Life Quality Index&#59; ISS&#58; Itchy Severity Scale&#59; MCS&#58; Mental Component Scale&#59; NRS&#58; Numerical rating ScalePCS&#58; Physical Component Scale&#59; PO-SCORAD&#58; Patient Oriented Scoring Atopic Dermatitis&#59; POEM&#58; Patient-Oriented Eczema Measure&#59; PSQI&#58; Pittsburgh Sleep Quality IndexSF-36&#58; Short Form-36&#59; VAS&#58; Visual Analogue Scale&#59; WPAI&#58; Work Productivity and Activity Impairment&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PRO category&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PROM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Type&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Target population&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Domains and&#47;or aspects evaluated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Items&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Period evaluated &#40;if available&#41;&#47;score range&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PROM validation or cross-cultural adaptation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&#44; cDLQI&#44; iDLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for dermatological conditions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;DLQI&#41;&#44; children &#40;cDLQI&#41; and infants &#40;iDLQI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Symptoms&#44; function and emotions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 0&#8211;30 &#40;0&#8211;1&#44; no effect on patient&#39;s life&#59; 2&#8211;5&#44; small effect&#59; 6&#8211;10&#44; moderate effect&#59; 11&#8211; 20&#44; very large effect&#59; and 21&#8211;30&#44; extremely large effect&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&#58; Developed in 1994 by Finlay et al&#46;<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">33</span></a> Transcultural adaptation into Spanish performed in 1998 by De Tiedra et al&#46;<a class="elsevierStyleCrossRef" href="#bib0575"><span class="elsevierStyleSup">51</span></a>cDLQI&#58; developed and validated in 1995 by Lewis-Jones et al&#46;<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">34</span></a>&#46;iDLQI&#58; developed and validated in 2001 by Lewis-Jones et al&#46;<a class="elsevierStyleCrossRef" href="#bib0495"><span class="elsevierStyleSup">35</span></a>&#46; cDLQI and iDLQI have a Spanish translation available at <span class="elsevierStyleInterRef" id="intr0005" href="http://www.cardiff.ac.uk/">http&#58;&#47;&#47;www&#46;cardiff&#46;ac&#46;uk&#47;</span>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADIS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient&#39;s feelings and the impact of AD on social activities&#44; leisure activities&#44; and patients&#8217; relationships<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">28</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adult version&#58; 9Children version&#58; 8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 0 &#40;minimum impact on HRQoL&#41; &#8211; 10 &#40;maximum impact on HRQoL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed and validated in Spain in 2012 and 2013&#44; respectively by Torrelo et al&#46;<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">28&#44;29</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ItchyQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Symptoms&#44; function and emotions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 0&#8211;110 &#40;0&#8211;30&#44; little impairment of HRQoL&#59; 31&#8211;50&#44; mild&#59; 51&#8211;80&#44; moderate&#59; and 81&#8211;110&#44; severe&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed and validated in 2008 by Desai et al<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">36</span></a>&#46; Validated in Spain by Zeidler et al&#46; in 2019<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">30</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SF-36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Physical Function&#59; Physical Role&#59; Body Pain&#59; General Health&#59; Vitality&#59; Social Function&#59; Emotional Role&#59; Mental Health and 2 summary components &#40;Physical and Mental&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; previous four weeksScore range&#58; 0&#8211;100 scale&#44; with higher scores indicating better health status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed in 1992 by Ware et al&#46;<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">38</span></a>&#46; Validated and translated into Spanish in 1995 by Alonso et al&#46;<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">37</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ISS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequency&#44; intensity and extend of pruritus&#46; Effect of pruritus on patient&#39;s mood&#44; sexual life &#40;adults&#41; and sleep<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">39</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adult version&#58; 7Children version&#58; 6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 0&#8211;21 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no presence of pruritus - 21<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>very severe pruritus&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Originally developed and validated in 2007 by Majeski et al&#46;<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">39</span></a>&#46; Validated in Spain in 2011 by Daud&#233;n et al&#46;<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">27</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intensity of pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; not specifiedScore range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no pruritus &#8211; 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>unbearable pruritus&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NRS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intensity of pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; the last 24<span class="elsevierStyleHsp" style=""></span>hScore range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no pruritus &#8211; 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>worst pruritus imaginable&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intensity of pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last 3 daysScore range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no pruritus &#8211; 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>unbearable pruritus&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validated in Europe in 2011 by Stalder et al&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">40</span></a>&#46;Spanish version available in https&#58;&#47;&#47;www&#46;poscorad&#46;com&#47;&#35;&#47;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sleep disturbances</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Presence of sleep disturbances&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no trouble sleeping &#8211; 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>unable to sleep&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Presence of sleep disturbances&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last three daysScore range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no trouble sleeping &#8211; 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>unable to sleep&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validated in Europe in 2011 by Stalder et al&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">40</span></a>&#46;Spanish version available in https&#58;&#47;&#47;www&#46;poscorad&#46;com&#47;&#35;&#47;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Question 4 &#8211; PSQI modified<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PSQI includes component scores &#40;10 items&#41; for&#58; Subjective sleep quality&#59; sleep latency&#59; sleep duration&#59; habitual sleep efficiency&#59; sleep disturbances&#59; use of sleeping medication&#59; daytime dysfunction<a class="elsevierStyleCrossRef" href="#bib0580"><span class="elsevierStyleSup">52</span></a>De Bruin Weller et al&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">18</span></a> only used a modification of question 4 of the PSQI questionnaire &#40;sleep duration&#41;&#58; &#8220;during the past week&#44; how many hours of actual sleep did you get at night&#63;&#8221;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last weekAverage hours of sleep during the last week<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">18</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Originally developed and validated in 1989 by Buysse et al&#46;<a class="elsevierStyleCrossRef" href="#bib0580"><span class="elsevierStyleSup">52</span></a>&#46; Validated in Spain in 1997 by Royuela-Rico et al&#46;<a class="elsevierStyleCrossRef" href="#bib0585"><span class="elsevierStyleSup">53</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Skin pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NRS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Level of skin pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; the last 24<span class="elsevierStyleHsp" style=""></span>hScore range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no pain - 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>worst imaginable pain&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disease control from the patient perspective&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Questionnaire based on Likert Scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Degree of disease control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 1&#8211;6 &#40;1<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>excellent disease control &#8211; 6<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>very poor control of the disease&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed in 2014 by Ortiz de Frutos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a>&#46; Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD severity from the patient perspective</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Surface affected&#44; severity of AD signs and intensity of symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last 3 days<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">40</span></a>Score range&#58; 0&#8211;103&#58; Surface affected and severity of signs &#40;7 items&#41; range 0&#8211;83&#59; intensity of symptoms &#40;2 items&#41; range 0&#8211;20&#40;0&#8211;24&#44; mild AD&#59; 25&#8211;49&#44; moderate AD&#59; &#8805;50&#44; severe AD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validated in Europe in 2011 by Stalder et al&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">40</span></a>&#46;Spanish version available in https&#58;&#47;&#47;www&#46;poscorad&#46;com&#47;&#35;&#47;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">POEM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequency of symptoms<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">41</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last 7 daysScore range&#58; 0&#8211;28 &#40;&#8804;7&#44; mild&#59; 8&#8211;16&#44; moderate&#59; &#62;16&#44; severe&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed and validated in 2004 by Charman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">41</span></a>&#46;Spanish version available &#40;linguistic validation certificate available in www&#46;nottingham&#46;ac&#46;uk&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient Global Assessment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Severity of disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; mild&#44; moderate or severe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Severity self-assessment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Severity of disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; clear&#44; almost clear&#44; mild&#44; moderate or severe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Treatment satisfaction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Overall satisfaction&#46; Degree of satisfaction with the prevention of flares&#44; lengthening of flare-free intervals&#44; frequency of treatment application&#44; information received about maintenance therapy&#44; and information received about treating flares during maintenance therapy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>minimum satisfaction- 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>maximum satisfaction&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adherence</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Morisky medication adherence scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Treatment adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; Patients were considered to have adhered to treatment if they answered &#8220;no&#8221; to questions 1&#44; 3&#44; and 4 and &#8220;yes&#8221; to question 2&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed and validated in 1986 by Morisky et al&#46;<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">43</span></a>&#46; Validated in Spain in 1992 by Val Jim&#233;nez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0540"><span class="elsevierStyleSup">44</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Questionnaire based on Likert Scale<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient adherence with the recommendations related to treatment&#44; skin hydration&#44; special soap use&#44; avoidance of high temperatures&#44; and food recommendations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 1&#8211;6 &#40;1<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>always apply or comply with the indication - 6<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>rarely or never apply&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed in 2014 by Ortiz de Frutos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a>&#46; Validation information not available&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anxiety and depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HADS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anxiety and depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 for anxiety<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>7 for depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last 7 daysScore range&#58; 0&#8211;21 &#40;0&#8211;7&#44; normal&#59; 8&#8211;10&#44; presence of anxiety or depression symptoms&#59; and 11&#8211;21&#44; clinical anxiety or depression&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed in 1983 by Zigmond et al&#46;<a class="elsevierStyleCrossRef" href="#bib0550"><span class="elsevierStyleSup">46</span></a>&#46; Spanish validation conducted in 2003 by Herrero et al&#46;<a class="elsevierStyleCrossRef" href="#bib0545"><span class="elsevierStyleSup">45</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Emotional consequences&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AESEC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Effect of AD on the patient emotional status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; not time-specificScore range&#58; 0&#8211;84 &#40;0&#8211;27&#44; &#8216;no&#47;small effect&#8217;&#59; 28&#8211;40&#44; &#8216;moderate effect&#8217;&#59; 40&#8211;52&#44; &#8216;large effect&#8217;&#59; and 53&#8211;84&#44; a &#8216;very large effect&#8217;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AESEC was developed and validated in two multi-country studies included in the review<a class="elsevierStyleCrossRefs" href="#bib0445"><span class="elsevierStyleSup">25&#44;32</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Family function&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Family APGAR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adaptation&#44; Partnership&#44; Growth&#44; Affection&#44; and Resolve&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; Patients have three choices of response&#58; &#8220;Almost always&#8221;&#44; &#8220;Some of the time&#8221;&#44; or &#8220;Hardly ever&#8221;&#46; The patient checks one of three options which are scored as follows&#58; &#8216;Almost always&#8217; &#40;2 points&#41;&#44; &#8216;Some of the time&#8217; &#40;1 point&#41;&#44; or &#8216;Hardly ever&#8217; &#40;0 points&#41;&#46; The scores for each of the five questions are then totalled&#46; A score of 7&#8211;10 suggests a highly functional family&#59; 4&#8211;6 suggests a moderately dysfunctional family&#59; 0&#8211;3 suggests a severely dysfunctional family&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed in 1978 by G Smilkstein<a class="elsevierStyleCrossRef" href="#bib0560"><span class="elsevierStyleSup">48</span></a>&#46; Validated in Spain in 1996 by Bellon-Saame&#241;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0555"><span class="elsevierStyleSup">47</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Work productivity and activity impairment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">WPAI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Absenteeism&#44; presenteeism&#44; overall work impairment&#44; and activity impairment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last 7 daysScore range&#58; WPAI outcomes are expressed as impairment percentages&#44; with higher numbers indicating greater impairment and less productivity&#44; i&#46;e&#46;&#44; worse outcomes&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed and validated in 1993 by Reilly et al&#46;<a class="elsevierStyleCrossRef" href="#bib0570"><span class="elsevierStyleSup">50</span></a> Linguistic validation into Spanish carried out in 2006 by Gawlicki et al&#46;<a class="elsevierStyleCrossRef" href="#bib0565"><span class="elsevierStyleSup">49</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient empowerment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DATEMP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 dimensions&#58; active self-care &#40;skills&#41;&#44; basic knowledge about the disease &#40;knowledge&#41;&#44; personal-social concerns &#40;coping skills&#41;&#44; and change intention &#40;change&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; the questionnaire evaluates the patient empowerment in the present time&#46;Score range&#58; 17&#8211;85 &#40;17&#44; low level of empowerment&#59; 85&#44; high level of empowerment&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pereyra-Rodriguez et al&#46; developed and validated this questionnaire in Spanish population<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">31</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2960445.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Only a modification of question 4 of PSQI questionnaire was used in de Bruin Weller et al&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">18</span></a> publication&#44; and therefore&#44; PSQI has not been counted among the identified PROMs&#46; Details on the domains and&#47;or aspects evaluated&#44; items&#44; period evaluated&#44; score range and PROM validation or cross-cultural adaptation have been obtained from the literature&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Characteristics of PROMs identified in observational studies involving AD patients in Spain&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:64 [
            0 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and comorbidity of atopic dermatitis in children&#58; a large-scale population study based on real-world data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46; Gilaberte"
                            1 => "J&#46;B&#46; Perez-Gilaberte"
                            2 => "B&#46; Poblador-Plou"
                            3 => "K&#46; Bliek-Bueno"
                            4 => "A&#46; Gimeno-Miguel"
                            5 => "A&#46; Prados-Torres"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Clin Med"
                        "fecha" => "2020"
                        "volumen" => "9"
                        "itemHostRev" => array:3 [
                          "pii" => "S1550728915001379"
                          "estado" => "S300"
                          "issn" => "15507289"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of atopic dermatitis in adultos&#58; results from an international survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Barbarot"
                            1 => "S&#46; Auziere"
                            2 => "A&#46; Gadkari"
                            3 => "G&#46; Girolomoni"
                            4 => "L&#46; Puig"
                            5 => "E&#46;L&#46; Simpson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
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Review
Patient-Reported Outcome Measures in Real-World Atopic Dermatitis Studies in Spain: A Systematic Review
Medidas de los resultados percibidos por el paciente en estudios de vida real en dermatitis atópica en España: revisión sistemática de la literatura
J.C. Armario-Hitaa, E. Artimeb, N. Vidal-Vilarc, T. Hueteb, S. Díaz-Cerezob,
Corresponding author
diaz_silvia@lilly.com

Corresponding author.
, R.M. Morob, L. Lizánc,d, F.J. Ortiz de Frutose
a Unidad de Dermatología, Hospital Universitario de Puerto Real, Universidad de Cádiz, Puerto Real, Cádiz, Spain
b Eli Lilly, Alcobendas, Spain
c Outcomes’10, S.L., Castellón de la Plana, Spain
d Departamento de Medicina, Universidad Jaume I, Castellón de la Plana, Spain
e Unidad de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain
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          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Frequency of PROMs used in the 17 observational studies&#46; ADIS&#58; Atopic Dermatitis Impact Scale&#59; AESEC&#58; Atopic Eczema Score of Emotional Consequences&#59; cDLQI&#58; children Dermatology Life Quality Index&#59; DATEMP&#58; Dermatitis AT&#243;pica EMPoderamiento&#59; DLQI&#58; Dermatology Quality of Life Index&#59; HADS&#58; Hospital Anxiety and Depression Scale&#59; iDLQI&#58; infant Dermatology Life Quality Index&#59; ISS&#58; Itchy Severity Scale&#59; MCS&#58; Mental Component Scale&#59; NRS&#58; Numerical rating ScalePCS&#58; Physical Component Scale&#59; PO-SCORAD&#58; Patient Oriented Scoring Atopic Dermatitis&#59; POEM&#58; Patient-Oriented Eczema Measure&#59; SF-36&#58; Short Form-36&#59; VAS&#58; Visual Analogue Scale&#59; WPAI&#58; Work Productivity and Activity Impairment&#59; &#42;includes VAS for treatment satisfaction &#40;1&#41;&#44; VAS for pruritus &#40;3&#41;&#44; VAS for sleep disturbances &#40;1&#41;&#59; PO-SCORAD VAS for pruritus &#40;1&#41; and PO-SCORAD VAS for sleep disturbances &#40;1&#41;&#59; &#42;&#42;includes a Likert scale for disease control and a Likert scale for treatment adherence&#59; &#42;&#42;&#42;includes NRS for pruritus &#40;1&#41; and NRS for skin pain &#40;1&#41;&#59; <span class="elsevierStyleSup">i</span>One of the studies only evaluated the depression component of the questionnaire &#40;HADS-D&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Atopic dermatitis &#40;AD&#41; is a common chronic inflammatory skin disease&#44; affecting 15&#46;5&#37; of children<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">1</span></a> and 7&#46;2&#37; of adults in Spain&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">2</span></a> It is characterised by intense pruritus and recurrent eczematous lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">3</span></a> AD presents symptoms that may lead to interference in daily activities&#44; sleep disturbances&#44; skin pain&#44; impairment of psychosocial and work functioning&#44; and impact on health-related quality of life &#40;HRQoL&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">4&#44;5</span></a> causing a significant burden on patient&#39;s life&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Unlike other disorders&#44; for most dermatological diseases no objective marker of the disease progression is available&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">7</span></a> Consequently&#44; different clinician-reported outcome &#40;ClinRO&#41; measures have been developed to assess clinical signs&#44; and their severity and extent in AD&#44; e&#46;g&#46; Eczema Area and Severity Index &#40;EASI&#41;&#44; Investigator Global Assessment &#40;IGA&#41;&#44; validated IGA for AD &#40;vIGA-AD&#8482;&#41;&#44; SCORing Atopic Dermatitis &#40;SCORAD&#41;&#46; The latter also includes patient&#39;s perspective by evaluating the main symptoms of AD &#40;i&#46;e&#46; pruritus and sleep disturbances&#41;&#46; Assessing symptoms and their impact on daily activities&#44; work productivity&#47;functioning and HRQoL from patient&#39;s perspective is crucial to obtain a holistic view of the impact of the disease and determine its real burden&#46;<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">5&#44;7</span></a> Therefore&#44; patient-reported outcomes &#40;PROs&#41; are an essential complement to ClinRO in AD&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">5</span></a> For this reason&#44; several patient-reported outcome measures &#40;PROMs&#41; have been developed during the last decades and most recently integrated in the development and evaluation of new treatments for AD&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">PROMs are also an integral part of clinical trial programmes in AD&#46; In recent years&#44; a global initiative has appeared to Harmonize Outcome Measures for Eczema &#40;HOME&#41;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">8</span></a> in clinical trials&#46; This initiative has defined a core outcomes set and instruments including&#44; among others&#58; EASI&#44; to measure the signs of the disease&#59; the Patient-Oriented Eczema Measure &#40;POEM&#41;&#44; to collect patient-reported symptoms&#59; Numerical Rating Scale &#40;NRS&#41;&#44; for measuring the peak pruritus over the past 24<span class="elsevierStyleHsp" style=""></span>h&#59; and Dermatology Life Quality Index &#40;DLQI&#41;&#44; to assess HRQoL&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">8</span></a> HOME is currently working on defining a list of suitable instruments for measuring health domains in clinical practice&#44; where 5 domains have been agreed as the principal ones&#58; PRO&#44; disease&#47;flare control&#44; patient global assessment&#44; clinician-reported signs&#44; and eczema specific QoL&#46; POEM&#44; the Patient-oriented SCORAD index &#40;PO-SCORAD&#41;&#44; or both have been selected so far for measuring AD symptoms in clinical practice&#46; Additionally&#44; pruritus NRS has been provisionally recommended as an instrument for measuring pruritus intensity&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Many different PROMs are available to assess PROs in AD in clinical practice&#44; most of which focus on the symptoms and HRQoL impairment&#44; but none comprehensively assesses all aspects of the disease&#46; Due to this variety of instruments&#44; several international reviews of PROMs for AD are available in the literature&#44;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">9&#8211;11</span></a> but to date&#44; none has reviewed the instruments used in Spain for AD&#46; We conducted a systematic review to identify and describe specific PROMs used in AD studies conducted under real-world conditions during the last decade in Spain&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We conducted a systematic review of the literature to identify studies that validated and&#47;or used PROMs for AD in the context of clinical practice in Spain&#46; Spanish &#40;MEDES&#44; IBECS&#41; and international &#40;PubMed&#47;MEDLINE&#41; databases were searched&#46; This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses &#40;PRISMA&#41; recommendations&#44;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">12</span></a> and the recommendations set out in the Cochrane Handbook for Systematic Reviews of Interventions&#46;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">13</span></a> Additionally&#44; a broad search in the grey literature&#44; including specific PRO research tools databases &#40;BiblioPRO&#44; PROQOLID&#41;&#44; the Spanish &#40;AEDV&#41; and European &#40;EADV&#41; Dermatology congress websites&#44; and Google&#47;Google Scholar&#44; was performed&#46; Lastly&#44; the reference lists of retrieved articles were reviewed to complement the systematic search&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The search strategy was focused on disease-related terms&#44; PROs and PROMs&#44; and country of interest &#40;Table S1&#44; Appendix additional material&#41;&#46; The search was limited to original articles and congress communications published in English or Spanish&#44; between April 1&#44; 2010 and April 1&#44; 2020&#46; Publications that reported observational and&#47;or epidemiological studies including Spanish patients with AD&#44; describing the validation of PROMs or the use of tools to measure PROs in AD&#44; were selected&#46; Reviews and opinion articles&#44; letters to the director and clinical trials were excluded from the review&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">After removal of duplicates&#44; two independent researchers selected the eligible publications applying the pre-defined inclusion and exclusion criteria&#46; First&#44; researchers screened by title and abstract&#44; discarding publications outside the scope of the review&#46; Full-text publications were subsequently reviewed&#46; Discrepancies during the selection or evaluation process were resolved by consensus with the involvement of a third researcher&#46; Two independent reviewers extracted data from selected publications&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Selected publications were categorised according to the study objectives in&#58; &#8220;use of PROMs&#8221;&#44; &#8220;use and validation of PROMs&#8221; and &#8220;validation of PROMs&#8221;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Data from each study were extracted&#44; including year of publication&#44; study design&#44; setting &#40;national or multinational&#41;&#44; population type &#40;adults and&#47;or children&#41; and size&#44; condition evaluated &#40;AD or dermatological conditions including AD&#41;&#44; PROs evaluated&#44; and PROMs used&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">For each PROM&#44; extracted data included&#58; outcome measure&#44; type &#40;generic&#47;specific&#41;&#44; target population&#44; domains and&#47;or aspects evaluated&#44; number of items&#44; period evaluated&#44; score range&#44; and the reference of the PROM validation or cross-cultural adaptation&#46; Where information was not available from the retrieved publications&#44; other available literature and PROMs developers&#8217; official websites were reviewed&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Data were summarised descriptively with frequencies and percentages&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">To assess the quality of the included observational studies we used the Strengthening the Reporting of Observational Studies in Epidemiology &#40;STROBE&#41; statement&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">14</span></a> The results of STROBE were calculated as the number of the 22 items adequately reported divided by the number of items&#44; expressed as a percentage&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">A total of 227 potentially relevant titles were initially recovered&#44; 17 of which were considered eligible for inclusion&#46; Two additional publications were identified during our search of key reference lists&#59; hence 19 publications were finally included in the review&#46; Of them&#44; 13 reported the use of PROMs&#44;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">2&#44;15&#8211;26</span></a> five reported the use of PROMs and validation of at least one PROM in Spanish population&#44;<a class="elsevierStyleCrossRefs" href="#bib0455"><span class="elsevierStyleSup">27&#8211;31</span></a> and one reported exclusively the validation of a PROM<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">32</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Characteristics of the identified observational studies</span><p id="par0070" class="elsevierStylePara elsevierViewall">The 19 publications included in the review described 17 different observational studies &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; conducted in the last ten years&#46; Most of these studies &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41; were published in the 2018&#8211;2020 period&#46; Sixty-five percent &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41; of the studies had a cross-sectional design&#44;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">2&#44;17&#44;19&#8211;21&#44;24&#44;25&#44;28&#8211;31</span></a> 24&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#41; were retrospective&#44;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">15&#44;16&#44;18&#44;22&#44;23&#44;26&#44;27</span></a> and 12&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41; were prospective&#46;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">15&#44;22&#44;27</span></a> Regarding the geographical scope&#44; 65&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>11&#41; were carried out only in Spain&#46;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">15&#44;16&#44;18&#44;19&#44;21&#8211;23&#44;26&#8211;29&#44;31</span></a> Concerning the study population and the condition evaluated&#44; 71&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12&#41; included only adult patients&#44;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">2&#44;16&#8211;18&#44;20&#44;21&#44;23&#8211;26&#44;30&#44;31</span></a> and 82&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&#41; only patients with AD&#46;<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">2&#44;15&#8211;19&#44;22&#8211;29&#44;31&#44;32</span></a> Lastly&#44; regarding the quality of reporting&#44; cross-sectional and prospective studies showed a high percentage of STROBE items adequately reported &#40;77&#8211;100&#37;&#41;&#44; however case series studies reported percentages below 60&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">16&#44;18&#44;23</span></a> STROBE was not evaluated in one study&#44; for which only the abstract was available &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">PROMs identified in the observational studies</span><p id="par0075" class="elsevierStylePara elsevierViewall">The 17 identified observational studies assessed 13 different PROs&#46; The PROs most frequently evaluated were HRQoL&#44; pruritus as a major symptom of AD&#44; and anxiety and depression&#46; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> represents the frequency of evaluation of PROs in the studies included in the review&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">A total of 18 different PROMs were used&#44; with DLQI and Visual Analogue Scales &#40;VAS&#59; three VAS and one PO-SCORAD VAS for pruritus&#44; one VAS and one PO-SCORAD VAS for sleep disturbances&#41; as the most frequently applied to assess HRQoL and the symptoms of the disease&#44; respectively &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#44; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">HRQoL</span><p id="par0085" class="elsevierStylePara elsevierViewall">To evaluate HRQoL&#44; four different PROMs were used in thirteen observational studies&#44; some of them being administered simultaneously in the same study &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#46; Three PROMs were specific HRQoL questionnaires&#58; DLQI<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">15&#8211;18&#44;21&#44;23&#44;25&#44;27&#44;31</span></a> &#40;or its child &#40;cDLQI&#41; and infant &#40;iDLQI&#41; versions&#41;&#44; Atopic Dermatitis Impact Scale &#40;ADIS&#41;<a class="elsevierStyleCrossRefs" href="#bib0415"><span class="elsevierStyleSup">19&#44;28&#44;29</span></a> and ItchyQoL questionnaire&#46;<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">30</span></a> The other PROM identified was a generic HRQoL questionnaire&#58; Short Form-36 &#40;SF-36&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">24</span></a> DLQI&#44; cDLQI and iDLQI are specific questionnaires for dermatological conditions composed of 10 items&#44; which evaluate symptoms&#44; feelings&#44; and problems related to daily activities&#44; leisure&#44; work and school&#44; personal relationships&#44; and treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0485"><span class="elsevierStyleSup">33&#8211;35</span></a> ADIS is a specific questionnaire for AD that can be administered to adults and children&#44; composed of 9 and 8 items&#44; respectively&#44; which assess patient&#39;s feelings and the impact of AD on social activities&#44; leisure activities&#44; and patients&#8217; relationships&#46;<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">28&#44;29</span></a> ItchyQoL is a specific questionnaire for pruritus used in adults&#44; composed of 22 items that evaluate symptoms&#44; function and emotions&#46;<a class="elsevierStyleCrossRefs" href="#bib0470"><span class="elsevierStyleSup">30&#44;36</span></a> Finally&#44; SF-36 is a generic questionnaire for adults&#44; composed of 36 items evaluating physical function&#44; physical role&#44; body pain&#44; general health&#44; vitality&#44; social function&#44; emotional role and mental health&#46; All these PROMs measure the impact of the disease on patients&#8217; HRQoL&#46;<a class="elsevierStyleCrossRefs" href="#bib0505"><span class="elsevierStyleSup">37&#44;38</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Symptoms and disease control</span><p id="par0090" class="elsevierStylePara elsevierViewall">Three symptoms were evaluated in the studies identified&#44; with pruritus being the most frequently assessed &#40;six studies&#41;&#44; followed by sleep disturbances &#40;two studies&#41; and skin pain &#40;one study&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Pruritus was assessed in the studies using a single PROM &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41; or two PROMs &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#46; Four different PROMs were employed&#58; the Itchy Severity Scale &#40;ISS&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">15&#44;21&#44;27</span></a> a VAS&#44;<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">16&#44;22&#44;26</span></a> a Numerical Rating Scale &#40;NRS&#41;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a> and the PO-SCORAD VAS&#46;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a> ISS is a specific tool for pruritus in skin diseases that quantifies the frequency&#44; intensity and extent of pruritus&#44; and its effect on patients&#8217; mood&#44; sexual life and sleep&#44; in adults and children through a 7- and 6-items questionnaire&#44; respectively&#46;<a class="elsevierStyleCrossRefs" href="#bib0455"><span class="elsevierStyleSup">27&#44;39</span></a> The NRS and VAS are generic unidimensional scales administered to adults to evaluate the pruritus intensity&#44; while the PO-SCORAD VAS has been developed and validated also for use in children&#46;<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">34</span></a> To assess the presence of sleep disturbances one study used a generic VAS&#44;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">22</span></a> while another one used three different measures<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a>&#58; PO-SCORAD VAS&#44; question 2 of POEM &#40;&#8220;Over the last week&#44; on how many nights has your sleep been disturbed because of your eczema&#63;&#8221;&#41;&#44; and a modification of question 4 of the Pittsburgh Sleep Quality Index &#40;PSQI&#41; &#40;&#8220;During the past week&#44; how many hours of actual sleep did you get at night&#63;&#8221;&#41;&#46; Finally&#44; the level of skin pain was assessed in adults using a NRS&#46;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">The degree of disease control from the patient perspective was assessed in one study using a questionnaire based on a 6-point Likert scale&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">AD severity from the patient perspective</span><p id="par0105" class="elsevierStylePara elsevierViewall">AD severity from patient perspective was evaluated in the studies with a single PROM &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41; or three PROMs &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#41;&#46; The four PROMs identified were&#58; PO-SCORAD&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">2</span></a> POEM&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">2</span></a> Patient Global Assessment &#40;where the patient assessed the disease as mild&#44; moderate or severe&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">2</span></a> and a self-assessment of the severity &#40;clear&#44; almost clear&#44; mild&#44; moderate or severe&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">25</span></a> The PO-SCORAD is a disease-specific tool that can be used in adults and children and comprises 7 items measuring the severity of AD signs &#40;surface area affected by eczema in the last 3 days&#44; dryness of the skin without eczema&#44; evaluation of the severity of the eczema over the last 3 days&#41;&#44; and two Visual Analogue Scales &#40;PO-SCORAD VAS&#41; to assess the intensity of symptoms &#40;pruritus and sleep disturbances&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">40</span></a> POEM is a specific questionnaire designed for use in adult patients with AD&#44; composed of 7 items that assess AD severity by evaluating the frequency of symptoms &#40;dryness&#44; pruritus&#44; flaking&#44; cracking&#44; sleep loss&#44; bleeding&#44; weeping&#41; per week&#46;<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">41</span></a> Although not identified in our review&#44; a children&#39;s version is also available&#46;<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">42</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Treatment satisfaction</span><p id="par0110" class="elsevierStylePara elsevierViewall">Patient satisfaction with maintenance therapy for AD was determined in one study using multiple VAS&#46;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">29</span></a> Different aspects of satisfaction were evaluated&#44; including overall satisfaction&#44; satisfaction with the prevention of flares&#44; satisfaction with lengthening of flare-free intervals&#44; satisfaction with frequency of treatment application&#44; satisfaction with information received about maintenance therapy&#44; and satisfaction with information received about treating flares during maintenance therapy&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Adherence</span><p id="par0115" class="elsevierStylePara elsevierViewall">Two PROMs were used to assess adherence in two studies&#58; the Morisky medication adherence scale&#44;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">29</span></a> a validated generic questionnaire&#44;<a class="elsevierStyleCrossRefs" href="#bib0535"><span class="elsevierStyleSup">43&#44;44</span></a> was used to measure treatment adherence&#44; while a questionnaire based on a 6-point Likert scale<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a> was employed to evaluate adherence to medical recommendations&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Psychosocial impact</span><p id="par0120" class="elsevierStylePara elsevierViewall">The psychosocial impact of AD was evaluated in four studies using a single PROM &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41; or two PROMs &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#46; The presence of anxiety and depression associated to AD was assessed through the Hospital Anxiety and Depression Scale &#40;HADS&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">17&#44;20&#44;21&#44;25</span></a> HADS is a generic questionnaire for adults composed of two subscales&#44; one of them measuring the presence of anxiety &#40;7 items&#41; and the other depression &#40;7 items&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0545"><span class="elsevierStyleSup">45&#44;46</span></a> The Atopic Eczema Score of Emotional Consequences &#40;AESEC&#41;&#44; a specific questionnaire for adults with AD composed of 28 items&#44; was used to determine the effect of AD on the patient emotional status&#46;<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">25</span></a> The psychometric properties of AESEC were reported in detail by Arents et al&#46;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">32</span></a> The Family APGAR&#44; a generic questionnaire for adults composed of 5 items&#44;<a class="elsevierStyleCrossRefs" href="#bib0555"><span class="elsevierStyleSup">47&#44;48</span></a> allowed to assess how family function &#40;adaptation&#44; partnership&#44; growth&#44; affection&#44; and resolve&#41; was affected by AD&#46;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">21</span></a></p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Work productivity and activity impairment</span><p id="par0125" class="elsevierStylePara elsevierViewall">The work productivity &#40;including absenteeism&#44; presenteeism&#44; overall work impairment&#44; and activity impairment&#41; was evaluated in one study using Work Productivity and Activity Impairment &#40;WPAI&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">24</span></a> a generic questionnaire for adults composed of 6 items&#46;<a class="elsevierStyleCrossRefs" href="#bib0565"><span class="elsevierStyleSup">49&#44;50</span></a></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Patient empowerment</span><p id="par0130" class="elsevierStylePara elsevierViewall">The level of patient empowerment was assessed in one study using the Dermatitis AT&#243;pica EMPoderamiento &#40;DATEMP&#41;&#44; a specific questionnaire for adults with AD&#44; originally developed and validated in Spanish&#44; composed of 17 items&#44; which evaluates aspects such as active self-care&#44; basic knowledge about the disease&#44; personal-social concerns&#44; and intention to change&#46;<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">31</span></a></p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0135" class="elsevierStylePara elsevierViewall">This review identified and described PROMs used in observational studies in AD in Spain during the last 10 years to assess key aspects of the disease from the patients&#8217; perspective&#46; The identified PROMs assessed the occurrence of symptoms &#40;e&#46;g&#46;&#44; pruritus&#41; and disease severity&#44; interference with daily activities&#44; impact on psychosocial and work functioning&#44; patient empowerment and HRQoL&#46; This review provides dermatologists an overview of tools available to measure PROs in observational studies with applicability in clinical practice in Spain&#46; The growing interest in measuring PRO outcomes to obtain the patient perspective is reflected in the results of the review&#44; with more than half of the observational studies identified published in the last three years&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">In total&#44; eighteen different PROMs were identified&#58; 55&#37; were generic &#40;applicable to a wide range of conditions&#41;&#44; 6&#37; specific for dermatological conditions &#40;applicable to different skin disorders&#41;&#44; 11&#37; specific for pruritus &#40;one of the main symptoms of AD&#41;&#44; and one third specific for AD&#46; Both specific measures for dermatology and AD provide a complementary view of affected areas&#47;domains that are not assessed with generic instruments&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">The PROMs identified assessed thirteen distinct patient outcomes&#44; where HRQoL&#44; symptoms &#40;mainly pruritus&#41; and anxiety&#47;depression were the most frequently evaluated&#46; These findings are in line with a previous systematic review identifying PROMs used in clinical trials to assess new treatments in AD&#44; where tools to evaluate HRQoL and pruritus&#44; were the most frequently employed&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">5</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Our review shows that DLQI and its children and infant versions are also the most frequently used in observational studies in Spain&#46; Despite not being an AD specific tool&#44; DLQI has been widely used as a HRQoL measure in dermatology clinical trials&#44; validated in AD patients&#44; and included in HOME recommendations from 2017&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">9</span></a> Even though previous studies have shown a significant correlation between HRQoL measures such as DLQI and AD severity&#44; there is scarce information about the routine use of HRQoL measures in the management of patients with AD&#46;<a class="elsevierStyleCrossRef" href="#bib0590"><span class="elsevierStyleSup">54</span></a> This review underlines the widespread use of DLQI in observational studies in dermatology in Spain&#46; Moreover&#44; its inclusion as an outcome suggests that it is feasible to integrate information about the impact of the disease and its symptoms on HRQoL under clinical practice conditions&#46; Measuring tools such as DLQI may help to better assess how well the disease is being managed&#47;controlled and the effectiveness of treatments beyond objective clinical assessment&#46; Nevertheless&#44; DLQI subscales have previously shown a considerable floor effect &#40;which makes it difficult to detect worsening of perceived HRQoL&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0595"><span class="elsevierStyleSup">55</span></a> and last HOME systematic review of HRQoL measures indicated insufficient structural validity for DLQI to be recommended for use&#46;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">11</span></a>Some authors recommend adding a generic to a dermatology-specific PROM&#44; to measure individuals&#8217; health status in generic terms&#44; and in situations where the skin disease has a substantial generic HRQoL impact beyond the disease-specific impact&#46;<a class="elsevierStyleCrossRefs" href="#bib0605"><span class="elsevierStyleSup">57&#44;58</span></a> Our review identified SF-36 as a possible available generic HRQoL tool for Spanish population&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">According to the last HOME consensus&#44;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">6</span></a> patient-reported symptoms is the highest-prioritized domain to measure in clinical practice in patients with atopic eczema&#46; In our review&#44; symptoms were measured as a stand-alone outcome &#40;using VAS or NRS&#41; or together with other aspects of the disease as part of a comprehensive PROM&#44; such as PO-SCORAD&#44; POEM or HRQoL questionnaires&#46; Symptoms&#44; as a stand-alone outcome&#44; were evaluated in a third of the studies reviewed&#46;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">15&#8211;17&#44;21&#44;22&#44;26&#44;27</span></a> Pruritus was assessed in all of them&#44; with pruritus VAS as the most used PROM &#40;67&#37;&#41;&#44; unlike the recommendations of HOME&#44; that provisionally recommend a NRS as preferred tool to measure pruritus intensity&#46; Sleep disturbances were evaluated in one third of the studies assessing patient-reported symptoms as a stand-alone outcome&#44;<a class="elsevierStyleCrossRefs" href="#bib0405"><span class="elsevierStyleSup">17&#44;22</span></a> and skin pain in 17&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a> Although they are the major symptoms in AD and a relevant domain for clinical trials&#44; they are not yet seen as a standard measure for clinical practice&#46; In a previous systematic review evaluating symptom reporting in clinical trials in AD&#44; it was found that 78&#37; of them used PROMs to assess symptoms&#44; of which only 37&#37; measured symptoms as stand-alone outcomes&#46; Among them&#44; pruritus was the most assessed symptom &#40;98&#37;&#41;&#44; with VAS being the most used PROM &#40;76&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0600"><span class="elsevierStyleSup">56</span></a> followed by sleep disturbance &#40;61&#37;&#41;&#44; which is largely considered a surrogate of pruritus&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Since in patients with moderate and severe AD the symptomatology can impact on patient&#39;s daily living activities and emotional wellbeing&#44;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">15</span></a> measuring symptoms&#44; especially pruritus&#44; becomes a key point in the evaluation of the disease&#46; Our review has identified both unidimensional &#40;VAS or NRS&#41; and multidimensional tools &#40;PO-SCORAD or POEM&#41; to evaluate pruritus&#46; Although unidimensional scales and PO-SCORAD assess the intensity of itching&#44; and POEM collects its frequency&#44; multidimensional tools provide a more holistic view of the disease&#44; and they have been previously correlated with the severity of AD and different dimensions of HRQoL&#46;<a class="elsevierStyleCrossRef" href="#bib0605"><span class="elsevierStyleSup">57</span></a> However&#44; the use of these instruments in clinical practice is scarce and limited to clinical research&#44; and according to HOME initiative&#44; unidimensional scales are preferred as a simple and rapid method for pruritus intensity assessment in clinical practice&#46;<a class="elsevierStyleCrossRefs" href="#bib0615"><span class="elsevierStyleSup">59&#8211;62</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">Our results show that the AD&#39;s psychosocial impact&#44; including anxiety and depression&#44; emotional consequences and family function are PROs evaluated in recent observational studies identified&#46; Among them&#44; anxiety and depression have been the most assessed PROs and HADS questionnaire the main PROM used&#46; This is in alignment with the high burden of psychiatric-related disorders reported in the literature among patients with AD in Spain e&#46;g&#46; de Bruin-Weller et al&#46; report the presence of emotional or mental comorbidity in 17&#8211;31&#37; of patients with mild to severe AD&#44; respectively&#44; which increases with disease severity&#46;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a> Higher prevalence of anxiety and depression in patients with AD compared to patients without AD has been reported&#44; associating worse HADS scores with worse disease severity&#46;<a class="elsevierStyleCrossRef" href="#bib0635"><span class="elsevierStyleSup">63</span></a> Additionally&#44; Spanish patients experiencing chronic pruritus present statistically significant differences for the anxiety subscale of HADS compared to those who do not experience chronic pruritus&#46;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">21</span></a> Because of the association between AD and psychiatric disorders&#44; HADS could be a useful tool in clinical practice to assess the mental health of these patients&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Recently&#44; an international study in adult patients with AD has evidenced the high impact on patient productivity and activity&#44; with a greater negative impact on patients with moderate and severe disease&#46;<a class="elsevierStyleCrossRef" href="#bib0640"><span class="elsevierStyleSup">64</span></a> Reducing the severity of the AD can be expected to decrease the burden on the patient and therefore the impact on productivity and activity&#44; which could be an aspect to be taken into account to assess in clinical practice&#46; However&#44; current review has identified only one study assessing the impact of AD on work productivity and activity through the WPAI questionnaire&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Finally&#44; in our review&#44; the Morisky medication adherence scale was the PROM chosen to evaluate patient adherence to treatment&#44;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">29</span></a> while a Likert Scale was used to measure adherence to medical recommendations&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a> To assess patient&#39;s satisfaction a VAS was employed&#46;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">29</span></a> These results highlight the possible underestimation of the impact of adherence and patient satisfaction with treatment in AD patients&#44; as only two publications evaluate them&#44; relevant to assess the effectiveness of the prescribed treatment&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Despite the increasing number of studies evaluating PROMs in our review&#44; the systematic use of tools to capture patient perception for a holistic management of AD in Spain is still scarce&#46; The limited use of PROMs in clinical practice could be due to the reduced time in consultations&#44; the lack of collaboration or inability of patients to complete PROMs&#44; the lack of habit in incorporating the patient in decision making&#44; and the current healthcare model where the patient&#39;s empowerment is low&#46; Nevertheless&#44; our results show that the use of PROMs in clinical practice could be increasing since the patient&#39;s perspective is becoming more relevant to the clinician in disease management&#46; There is still scope for increased measurement of patient-reported symptoms and its consequences on different aspects of patient&#39;s life&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">This review&#39;s main strength is the systematic approach used and the focus on PROs assessed in observational studies&#44; which allowed to provide an overview of identified PROMs that may be applicable for use in routine clinical practice conditions&#46; This review is not exempt of limitations&#46; Although STROBE checklist was used to determine the quality of the included observational studies&#44; the review did not analyse the possible biases of the included observational studies&#46; In addition&#44; the review included international studies involving Spanish patients with AD regardless of their sample size&#46; Therefore&#44; their results may not be an accurate representation of our setting&#46; However&#44; the review&#39;s objective was not to analyse the results obtained in those studies but to identify possible PROMs used in real-world studies that may have applicability in clinical practice&#46; Lastly&#44; our review was not designed to be a comprehensive review of all available PROMs but rather to identify PROMs used in real-world studies as these may provide a better reflection of routine clinical practice in Spain&#46; As such&#44; PROMs used in clinical trials and those not reported in observational studies including Spanish patients over the last decade were excluded&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusions</span><p id="par0190" class="elsevierStylePara elsevierViewall">The number of real-world studies that include PROMs conducted in Spanish AD patients has increased over time&#44; suggesting a growing importance of PROs in assessing and managing AD from a patient-centred point of view&#46; Several validated PROMs are available for use in Spain&#44; covering the main aspects of the disease&#44; including symptoms &#40;e&#46;g&#46; pruritus&#41; and disease severity&#44; interference with daily activities&#44; impact on psychosocial and work functioning&#44; patient empowerment and HRQoL&#46; However&#44; there is still scope for increasing the measurement of patient-reported symptoms to understand their consequences and impact on patient&#39;s life in terms of disease progression and treatment effectiveness&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicts of interest</span><p id="par0195" class="elsevierStylePara elsevierViewall">Lilly Spain has financed the publication of this article&#46;</p></span></span>"
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      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Atopic dermatitis &#40;AD&#41; is a chronic inflammatory skin disease with symptoms such as pruritus that can be a major burden for patients&#46; Patient-reported outcomes &#40;PRO&#41; complement clinician-reported outcomes in AD&#46; This systematic review aims to identify and describe patient-reported outcome measures &#40;PROM&#41; used in observational studies of AD over the last decade in Spain&#46; Eighteen PROM were identified to measure 13 different PRO that assess multiple aspects of the disease&#44; including symptoms and disease severity&#44; impact on daily activities and on work productivity&#47;functioning&#44; psychosocial impact&#44; patient empowerment&#44; and health-related quality of life &#40;HRQoL&#41;&#46; HRQoL&#44; symptoms &#40;particularly pruritus&#41;&#44; and anxiety&#47;depression were the most frequently assessed PRO&#44; and the Dermatology Quality of Life Index&#44; the Visual Analogue Pruritus Scale&#44; and the Hospital Anxiety and Depression Scale were the most frequently used PROM&#44; respectively&#46; The growing number of observational studies on AD including PROM in Spain suggests that PRO are becoming increasingly important in the management of AD&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La dermatitis at&#243;pica &#40;DA&#41; es una enfermedad cut&#225;nea inflamatoria cr&#243;nica con s&#237;ntomas tales como el prurito&#44; que pueden causar una carga significativa en la vida del paciente&#46; Los resultados percibidos por los pacientes &#40;PRO&#41; complementan a los resultados cl&#237;nicos evaluados en la DA por los m&#233;dicos&#46; Esta revisi&#243;n sistem&#225;tica tiene como objetivo identificar y describir las medidas de los resultados percibidos por los pacientes &#40;PROM&#41; utilizadas en estudios observacionales de DA durante la &#250;ltima d&#233;cada en Espa&#241;a&#46; Se identificaron 18 PROM para medir 13 PRO diferentes que eval&#250;an m&#250;ltiples aspectos de la enfermedad&#44; incluyendo los s&#237;ntomas y la gravedad de la enfermedad&#44; la interferencia con las actividades diarias&#44; el impacto psicosocial y laboral&#44; el empoderamiento del paciente y la calidad de vida relacionada con la salud &#40;CVRS&#41;&#46; La CVRS&#44; los s&#237;ntomas &#40;principalmente el prurito&#41; y la ansiedad&#47;depresi&#243;n fueron los PRO m&#225;s evaluados&#44; siendo el <span class="elsevierStyleItalic">Dermatology Life Quality Index</span>&#44; la Escala Visual Anal&#243;gica del prurito y la <span class="elsevierStyleItalic">Hospital Anxiety and Depression Scale</span>&#44; las PROM m&#225;s frecuentemente empleadas&#44; respectivamente&#46; El n&#250;mero creciente de estudios observacionales sobre DA que incluyen PROM en Espa&#241;a sugiere un aumento de la importancia de los PRO en el manejo de la DA&#46;</p></span>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1980
            "Ancho" => 2925
            "Tamanyo" => 306268
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Publication selection flowchart according to PRISMA&#46; MEDES&#58; MEdicina en ESpa&#241;ol&#59; IBECS&#58; &#205;ndice Bibliogr&#225;fico Espa&#241;ol en Ciencias de la Salud&#59; AEDV&#58; Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a&#59; EADV&#58; European Academy of Dermatology and Venereology&#59; PROM&#58; Patient-Reported Outcomes Measure&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1062
            "Ancho" => 2341
            "Tamanyo" => 143825
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Frequency of evaluation of PROs in the 17 observational studies&#46; AD&#58; atopic dermatitis&#59; HRQoL&#58; Health-Related Quality of Life&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 2054
            "Ancho" => 2508
            "Tamanyo" => 178439
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Frequency of PROMs used in the 17 observational studies&#46; ADIS&#58; Atopic Dermatitis Impact Scale&#59; AESEC&#58; Atopic Eczema Score of Emotional Consequences&#59; cDLQI&#58; children Dermatology Life Quality Index&#59; DATEMP&#58; Dermatitis AT&#243;pica EMPoderamiento&#59; DLQI&#58; Dermatology Quality of Life Index&#59; HADS&#58; Hospital Anxiety and Depression Scale&#59; iDLQI&#58; infant Dermatology Life Quality Index&#59; ISS&#58; Itchy Severity Scale&#59; MCS&#58; Mental Component Scale&#59; NRS&#58; Numerical rating ScalePCS&#58; Physical Component Scale&#59; PO-SCORAD&#58; Patient Oriented Scoring Atopic Dermatitis&#59; POEM&#58; Patient-Oriented Eczema Measure&#59; SF-36&#58; Short Form-36&#59; VAS&#58; Visual Analogue Scale&#59; WPAI&#58; Work Productivity and Activity Impairment&#59; &#42;includes VAS for treatment satisfaction &#40;1&#41;&#44; VAS for pruritus &#40;3&#41;&#44; VAS for sleep disturbances &#40;1&#41;&#59; PO-SCORAD VAS for pruritus &#40;1&#41; and PO-SCORAD VAS for sleep disturbances &#40;1&#41;&#59; &#42;&#42;includes a Likert scale for disease control and a Likert scale for treatment adherence&#59; &#42;&#42;&#42;includes NRS for pruritus &#40;1&#41; and NRS for skin pain &#40;1&#41;&#59; <span class="elsevierStyleSup">i</span>One of the studies only evaluated the depression component of the questionnaire &#40;HADS-D&#41;&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Author &#40;year&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study design&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Geography&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Population type and size &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Condition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PRO evaluated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PROMs used&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">STROBE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Daud&#233;n et al&#46; &#40;2011&#41;<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">27</span></a>&#44; Sanchez Perez at al&#46; &#40;2013&#41;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">15</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospective</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;172&#41; and children &#40;151&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ISS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#47;2286&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&#44; cDLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Torrelo et al&#46; &#40;2012&#41;<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">28</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;159&#41; and children &#40;163&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADIS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#47;2295&#37; of items well-reported&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Torrelo et al&#46; &#40;2013&#41;<a class="elsevierStyleCrossRef" href="#bib0465"><span class="elsevierStyleSup">29</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;141&#41; and children &#40;141&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&#44; cDLQI&#44; iDLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#47;22100&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADIS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Morisky medication adherence scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Satisfaction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ortiz de Frutos et al&#46; &#40;2014&#41;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;125&#41; and children &#40;116&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADIS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#47;2295&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disease control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Likert scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Likert scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dalgard et al&#46; &#40;2015&#41;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">20</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multinational &#40;BE&#44; DK&#44; FR&#44; DE&#44; HU&#44; IT&#44; NL&#44; NO&#44; PL&#44; RU&#44; SP&#44; TR&#44; UK&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Several dermatological conditions including AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anxiety&#47;depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HADS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#47;22100&#37; of items well-reported&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Marron et al&#46; &#40;2016&#41;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">21</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;11&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Several dermatological conditions including AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ISS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#47;2277&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anxiety&#47;depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HADS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Family function&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Family APGAR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Barbarot et al&#46; &#40;2018&#41;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">2</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multinational &#40;FR&#44; DE&#44; IT&#44; SP&#44; UK&#44; USA&#44; CA&#44; JP&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;9924&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disease severity from the patient perspective</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#47;22100&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">POEM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient Global Assessment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ib&#225;&#241;ez et al&#46;&#44; &#40;2018&#41;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">22</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prospective</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Children &#40;275&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#47;22100&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sleep disturbances&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Benavente Villegas et al&#46; &#40;2018&#41;<a class="elsevierStyleCrossRef" href="#bib0435"><span class="elsevierStyleSup">23</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospective case series&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#47;2232&#37; of items well-reported&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Zeidler at al&#46; &#40;2018&#41;<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">30</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multinational &#40;FR&#44; DE&#44; IT&#44; PO&#44; RU&#44; SP&#44; CH&#44; TR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Several dermatological conditions including AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ItchyQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#47;2291&#37; of items well reported&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eckert et al&#46; &#40;2019&#41;<a class="elsevierStyleCrossRef" href="#bib0440"><span class="elsevierStyleSup">24</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multinational &#40;FR&#44; DE&#44; IT&#44; SP&#44; UK&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SF-36 &#40;PCS and MCS&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#47;2295&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Work productivity and activity impairment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">WPAI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ring et al&#46; &#40;2019&#41;<a class="elsevierStyleCrossRef" href="#bib0445"><span class="elsevierStyleSup">25</span></a>&#44; Arents et al&#46; &#40;2019&#41;<a class="elsevierStyleCrossRef" href="#bib0480"><span class="elsevierStyleSup">32</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multinational &#40;FR&#44; SP&#44; IT&#44; UK&#44; DE&#44; NL&#44; DK&#44; SE&#44; CZ&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;180&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disease severity</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">POEM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#47;2286&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Self-assessment of severity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anxiety&#47;depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HADS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Emotional consequences&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AESEC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hernandez-Fernandez et al&#46; &#40;2019&#41;<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">26</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospective case series&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not calculated &#40;only abstract available&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ruiz-Villaverde et al&#46; &#40;2019&#41;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">16</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospective case series</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;30&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#47;2259&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pereyra-Rodriguez et al&#46; &#40;2019&#41;<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">31</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;17&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient Empowerment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DATEMP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#47;2282&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">de Bruin-Weller et al&#46; &#40;2020&#41;<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">17</span></a></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cross-sectional</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Multinational &#40;FR&#44; DE&#44; SP&#44; IT&#44; UK&#44; CA&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;290&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NRS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#47;2286&#37; of items well-reported</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NRS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sleep disturbances</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Question 2 of POEM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Question 4 of PSQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anxiety&#47;depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HADS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Brice&#241;o Casado et al&#46; &#40;2020&#41;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">18</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retrospective case series&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#47;2259&#37; of items well-reported&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
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          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">3720 international patients &#40;1860 with AD&#44; 1860 without AD&#41;&#44; 37&#37; of the sample were Spanish patients&#46; BE&#58; Belgium&#59; CA&#58; Canada&#59; CH&#58; Switzerland&#59; CZ&#58; Czech Republic&#59; DE&#58; Germany&#59; DK&#58; Denmark&#59; FR&#58; France&#59; HU&#58; Hungary&#59; IT&#58; Italy&#59; JP&#58; Japan&#59; NL&#58; Netherlands&#59; NO&#58; Norway&#59; PL&#58; Poland&#59; RU&#58; Russia&#59; SE&#58; Sweden&#59; SP&#58; Spain&#59; TR&#58; Turkey&#59; UK&#58; United Kingdom&#59; USA&#58; United States&#59; AD&#58; Atopic dermatitis&#59; ADIS&#58; Atopic Dermatitis Impact Scale&#59; AESEC&#58; Atopic Eczema Score of Emotional Consequences&#59; cDLQI&#58; children Dermatology Life Quality Index&#59; DATEMP&#58; Dermatitis AT&#243;pica EMPoderamiento&#59; DLQI&#58; Dermatology Quality of Life Index&#59; HADS&#58; Hospital Anxiety and Depression Scale&#59; HRQoL&#58; health Related Quality of Life&#59; iDLQI&#58; infant Dermatology Life Quality Index&#59; ISS&#58; Itchy Severity Scale&#59; MCS&#58; Mental Component Scale&#59; NRS&#58; Numerical rating ScalePCS&#58; Physical Component Scale&#59; PO-SCORAD&#58; Patient Oriented Scoring Atopic Dermatitis&#59; POEM&#58; Patient-Oriented Eczema Measure&#59; PSQI&#58; Pittsburgh Sleep Quality IndexSF-36&#58; Short Form-36&#59; VAS&#58; Visual Analogue Scale&#59; WPAI&#58; Work Productivity and Activity Impairment&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the observational studies included in the review&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
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        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">ADIS&#58; Atopic Dermatitis Impact Scale&#59; AESEC&#58; Atopic Eczema Score of Emotional Consequences&#59; cDLQI&#58; children Dermatology Life Quality Index&#59; DATEMP&#58; Dermatitis AT&#243;pica EMPoderamiento&#59; DLQI&#58; Dermatology Quality of Life Index&#59; HADS&#58; Hospital Anxiety and Depression Scale&#59; iDLQI&#58; infant Dermatology Life Quality Index&#59; ISS&#58; Itchy Severity Scale&#59; MCS&#58; Mental Component Scale&#59; NRS&#58; Numerical rating ScalePCS&#58; Physical Component Scale&#59; PO-SCORAD&#58; Patient Oriented Scoring Atopic Dermatitis&#59; POEM&#58; Patient-Oriented Eczema Measure&#59; PSQI&#58; Pittsburgh Sleep Quality IndexSF-36&#58; Short Form-36&#59; VAS&#58; Visual Analogue Scale&#59; WPAI&#58; Work Productivity and Activity Impairment&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PRO category&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PROM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Type&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Target population&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Domains and&#47;or aspects evaluated&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Items&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Period evaluated &#40;if available&#41;&#47;score range&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PROM validation or cross-cultural adaptation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HRQoL</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&#44; cDLQI&#44; iDLQI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for dermatological conditions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults &#40;DLQI&#41;&#44; children &#40;cDLQI&#41; and infants &#40;iDLQI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Symptoms&#44; function and emotions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 0&#8211;30 &#40;0&#8211;1&#44; no effect on patient&#39;s life&#59; 2&#8211;5&#44; small effect&#59; 6&#8211;10&#44; moderate effect&#59; 11&#8211; 20&#44; very large effect&#59; and 21&#8211;30&#44; extremely large effect&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DLQI&#58; Developed in 1994 by Finlay et al&#46;<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">33</span></a> Transcultural adaptation into Spanish performed in 1998 by De Tiedra et al&#46;<a class="elsevierStyleCrossRef" href="#bib0575"><span class="elsevierStyleSup">51</span></a>cDLQI&#58; developed and validated in 1995 by Lewis-Jones et al&#46;<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">34</span></a>&#46;iDLQI&#58; developed and validated in 2001 by Lewis-Jones et al&#46;<a class="elsevierStyleCrossRef" href="#bib0495"><span class="elsevierStyleSup">35</span></a>&#46; cDLQI and iDLQI have a Spanish translation available at <span class="elsevierStyleInterRef" id="intr0005" href="http://www.cardiff.ac.uk/">http&#58;&#47;&#47;www&#46;cardiff&#46;ac&#46;uk&#47;</span>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADIS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient&#39;s feelings and the impact of AD on social activities&#44; leisure activities&#44; and patients&#8217; relationships<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">28</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adult version&#58; 9Children version&#58; 8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 0 &#40;minimum impact on HRQoL&#41; &#8211; 10 &#40;maximum impact on HRQoL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed and validated in Spain in 2012 and 2013&#44; respectively by Torrelo et al&#46;<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">28&#44;29</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ItchyQoL&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Symptoms&#44; function and emotions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 0&#8211;110 &#40;0&#8211;30&#44; little impairment of HRQoL&#59; 31&#8211;50&#44; mild&#59; 51&#8211;80&#44; moderate&#59; and 81&#8211;110&#44; severe&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed and validated in 2008 by Desai et al<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">36</span></a>&#46; Validated in Spain by Zeidler et al&#46; in 2019<a class="elsevierStyleCrossRef" href="#bib0470"><span class="elsevierStyleSup">30</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SF-36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Physical Function&#59; Physical Role&#59; Body Pain&#59; General Health&#59; Vitality&#59; Social Function&#59; Emotional Role&#59; Mental Health and 2 summary components &#40;Physical and Mental&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; previous four weeksScore range&#58; 0&#8211;100 scale&#44; with higher scores indicating better health status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed in 1992 by Ware et al&#46;<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">38</span></a>&#46; Validated and translated into Spanish in 1995 by Alonso et al&#46;<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">37</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pruritus</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ISS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequency&#44; intensity and extend of pruritus&#46; Effect of pruritus on patient&#39;s mood&#44; sexual life &#40;adults&#41; and sleep<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">39</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adult version&#58; 7Children version&#58; 6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 0&#8211;21 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no presence of pruritus - 21<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>very severe pruritus&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Originally developed and validated in 2007 by Majeski et al&#46;<a class="elsevierStyleCrossRef" href="#bib0515"><span class="elsevierStyleSup">39</span></a>&#46; Validated in Spain in 2011 by Daud&#233;n et al&#46;<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">27</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intensity of pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; not specifiedScore range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no pruritus &#8211; 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>unbearable pruritus&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NRS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intensity of pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; the last 24<span class="elsevierStyleHsp" style=""></span>hScore range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no pruritus &#8211; 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>worst pruritus imaginable&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intensity of pruritus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last 3 daysScore range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no pruritus &#8211; 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>unbearable pruritus&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validated in Europe in 2011 by Stalder et al&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">40</span></a>&#46;Spanish version available in https&#58;&#47;&#47;www&#46;poscorad&#46;com&#47;&#35;&#47;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sleep disturbances</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Presence of sleep disturbances&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no trouble sleeping &#8211; 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>unable to sleep&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Presence of sleep disturbances&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last three daysScore range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no trouble sleeping &#8211; 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>unable to sleep&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validated in Europe in 2011 by Stalder et al&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">40</span></a>&#46;Spanish version available in https&#58;&#47;&#47;www&#46;poscorad&#46;com&#47;&#35;&#47;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Question 4 &#8211; PSQI modified<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PSQI includes component scores &#40;10 items&#41; for&#58; Subjective sleep quality&#59; sleep latency&#59; sleep duration&#59; habitual sleep efficiency&#59; sleep disturbances&#59; use of sleeping medication&#59; daytime dysfunction<a class="elsevierStyleCrossRef" href="#bib0580"><span class="elsevierStyleSup">52</span></a>De Bruin Weller et al&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">18</span></a> only used a modification of question 4 of the PSQI questionnaire &#40;sleep duration&#41;&#58; &#8220;during the past week&#44; how many hours of actual sleep did you get at night&#63;&#8221;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last weekAverage hours of sleep during the last week<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">18</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Originally developed and validated in 1989 by Buysse et al&#46;<a class="elsevierStyleCrossRef" href="#bib0580"><span class="elsevierStyleSup">52</span></a>&#46; Validated in Spain in 1997 by Royuela-Rico et al&#46;<a class="elsevierStyleCrossRef" href="#bib0585"><span class="elsevierStyleSup">53</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Skin pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NRS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Level of skin pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; the last 24<span class="elsevierStyleHsp" style=""></span>hScore range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>no pain - 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>worst imaginable pain&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disease control from the patient perspective&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Questionnaire based on Likert Scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Degree of disease control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 1&#8211;6 &#40;1<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>excellent disease control &#8211; 6<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>very poor control of the disease&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed in 2014 by Ortiz de Frutos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a>&#46; Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AD severity from the patient perspective</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PO-SCORAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Surface affected&#44; severity of AD signs and intensity of symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last 3 days<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">40</span></a>Score range&#58; 0&#8211;103&#58; Surface affected and severity of signs &#40;7 items&#41; range 0&#8211;83&#59; intensity of symptoms &#40;2 items&#41; range 0&#8211;20&#40;0&#8211;24&#44; mild AD&#59; 25&#8211;49&#44; moderate AD&#59; &#8805;50&#44; severe AD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validated in Europe in 2011 by Stalder et al&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">40</span></a>&#46;Spanish version available in https&#58;&#47;&#47;www&#46;poscorad&#46;com&#47;&#35;&#47;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">POEM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frequency of symptoms<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">41</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last 7 daysScore range&#58; 0&#8211;28 &#40;&#8804;7&#44; mild&#59; 8&#8211;16&#44; moderate&#59; &#62;16&#44; severe&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed and validated in 2004 by Charman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0525"><span class="elsevierStyleSup">41</span></a>&#46;Spanish version available &#40;linguistic validation certificate available in www&#46;nottingham&#46;ac&#46;uk&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient Global Assessment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Severity of disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; mild&#44; moderate or severe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Severity self-assessment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Severity of disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; clear&#44; almost clear&#44; mild&#44; moderate or severe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Treatment satisfaction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Overall satisfaction&#46; Degree of satisfaction with the prevention of flares&#44; lengthening of flare-free intervals&#44; frequency of treatment application&#44; information received about maintenance therapy&#44; and information received about treating flares during maintenance therapy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 0&#8211;10 &#40;0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>minimum satisfaction- 10<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>maximum satisfaction&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Validation information not available&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adherence</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Morisky medication adherence scale&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Treatment adherence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; Patients were considered to have adhered to treatment if they answered &#8220;no&#8221; to questions 1&#44; 3&#44; and 4 and &#8220;yes&#8221; to question 2&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed and validated in 1986 by Morisky et al&#46;<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">43</span></a>&#46; Validated in Spain in 1992 by Val Jim&#233;nez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0540"><span class="elsevierStyleSup">44</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Questionnaire based on Likert Scale<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults and children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient adherence with the recommendations related to treatment&#44; skin hydration&#44; special soap use&#44; avoidance of high temperatures&#44; and food recommendations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; 1&#8211;6 &#40;1<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>always apply or comply with the indication - 6<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>rarely or never apply&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed in 2014 by Ortiz de Frutos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">19</span></a>&#46; Validation information not available&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anxiety and depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HADS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anxiety and depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 for anxiety<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>7 for depression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last 7 daysScore range&#58; 0&#8211;21 &#40;0&#8211;7&#44; normal&#59; 8&#8211;10&#44; presence of anxiety or depression symptoms&#59; and 11&#8211;21&#44; clinical anxiety or depression&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed in 1983 by Zigmond et al&#46;<a class="elsevierStyleCrossRef" href="#bib0550"><span class="elsevierStyleSup">46</span></a>&#46; Spanish validation conducted in 2003 by Herrero et al&#46;<a class="elsevierStyleCrossRef" href="#bib0545"><span class="elsevierStyleSup">45</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Emotional consequences&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AESEC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Effect of AD on the patient emotional status&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; not time-specificScore range&#58; 0&#8211;84 &#40;0&#8211;27&#44; &#8216;no&#47;small effect&#8217;&#59; 28&#8211;40&#44; &#8216;moderate effect&#8217;&#59; 40&#8211;52&#44; &#8216;large effect&#8217;&#59; and 53&#8211;84&#44; a &#8216;very large effect&#8217;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AESEC was developed and validated in two multi-country studies included in the review<a class="elsevierStyleCrossRefs" href="#bib0445"><span class="elsevierStyleSup">25&#44;32</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Family function&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Family APGAR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adaptation&#44; Partnership&#44; Growth&#44; Affection&#44; and Resolve&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Score range&#58; Patients have three choices of response&#58; &#8220;Almost always&#8221;&#44; &#8220;Some of the time&#8221;&#44; or &#8220;Hardly ever&#8221;&#46; The patient checks one of three options which are scored as follows&#58; &#8216;Almost always&#8217; &#40;2 points&#41;&#44; &#8216;Some of the time&#8217; &#40;1 point&#41;&#44; or &#8216;Hardly ever&#8217; &#40;0 points&#41;&#46; The scores for each of the five questions are then totalled&#46; A score of 7&#8211;10 suggests a highly functional family&#59; 4&#8211;6 suggests a moderately dysfunctional family&#59; 0&#8211;3 suggests a severely dysfunctional family&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed in 1978 by G Smilkstein<a class="elsevierStyleCrossRef" href="#bib0560"><span class="elsevierStyleSup">48</span></a>&#46; Validated in Spain in 1996 by Bellon-Saame&#241;o et al&#46;<a class="elsevierStyleCrossRef" href="#bib0555"><span class="elsevierStyleSup">47</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Work productivity and activity impairment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">WPAI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Generic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Absenteeism&#44; presenteeism&#44; overall work impairment&#44; and activity impairment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; last 7 daysScore range&#58; WPAI outcomes are expressed as impairment percentages&#44; with higher numbers indicating greater impairment and less productivity&#44; i&#46;e&#46;&#44; worse outcomes&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Developed and validated in 1993 by Reilly et al&#46;<a class="elsevierStyleCrossRef" href="#bib0570"><span class="elsevierStyleSup">50</span></a> Linguistic validation into Spanish carried out in 2006 by Gawlicki et al&#46;<a class="elsevierStyleCrossRef" href="#bib0565"><span class="elsevierStyleSup">49</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient empowerment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DATEMP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Specific for AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 dimensions&#58; active self-care &#40;skills&#41;&#44; basic knowledge about the disease &#40;knowledge&#41;&#44; personal-social concerns &#40;coping skills&#41;&#44; and change intention &#40;change&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Period evaluated&#58; the questionnaire evaluates the patient empowerment in the present time&#46;Score range&#58; 17&#8211;85 &#40;17&#44; low level of empowerment&#59; 85&#44; high level of empowerment&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pereyra-Rodriguez et al&#46; developed and validated this questionnaire in Spanish population<a class="elsevierStyleCrossRef" href="#bib0475"><span class="elsevierStyleSup">31</span></a>&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Characteristics of PROMs identified in observational studies involving AD patients in Spain&#46;</p>"
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Article information
ISSN: 00017310
Original language: English
DOI:10.1016/j.ad.2022.05.010
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