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Patient-Reported Outcomes in Psoriasis Validated in Spain: PROs and Cons
Patient reported outcomes en psoriasis validados en España: PROs y contras
L. Puig
Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
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"apellidos" => "Puig" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731018305751" "doi" => "10.1016/j.ad.2018.12.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018305751?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019302227?idApp=UINPBA000044" "url" => "/15782190/0000011000000007/v1_201909021030/S1578219019302227/v1_201909021030/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Comentarios Editoriales</span>" "titulo" => "Patient-Reported Outcomes in Psoriasis Validated in Spain: PROs and Cons" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "518" "paginaFinal" => "519" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "L. Puig" "autores" => array:1 [ 0 => array:3 [ "nombre" => "L." "apellidos" => "Puig" "email" => array:1 [ 0 => "lpuig@santpau.cat" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Patient reported outcomes en psoriasis validados en España: PROs y contras" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">This issue of Actas Dermo-Sifiliográficas features a systematic review of studies that have validated or used patient-reported outcome tools in Spanish patients with psoriasis.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a> The review includes 5 tools that have been validated for use in Spain: 2 skin disease–specific quality of life questionnaires (the Dermatology Life Quality Index [DLQI] and Skindex-29), 2 psoriasis-specific questionnaires (the Psoriasis Disability Index [PDI]) and PSO-LIFE, which was developed in Spain), and a treatment satisfaction questionnaire (CESTEP), also developed for psoriasis patients in Spain. The authors are to be commended for their review of PRO tools that have been culturally adapted for use in Spain and for evaluating their characteristics.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Among the notable findings of the review is the weak to moderate—and variable—correlation observed between health-related quality of life (HRQoL) measures and clinical severity measured by the Psoriasis Area and Severity (PASI) index. The nature of this correlation can be explained by the fact that PASI may not capture the effects of lesions in certain areas of the body (hands, arms, genitals, scalp, and nails)<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">2</span></a> or those of certain symptoms and lesion visibility.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Although DLQI has a higher floor effect than Skindex-29, which is also more responsive to clinical changes,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">4</span></a> the introduction of a modified DLQI scoring system that takes into account “not relevant” responses<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">5</span></a> may help to overcome the notable floor effect of DLQI, which would have particularly important consequences when assessing female, elderly, unemployed, and less well-educated patients.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Other important considerations are the nonlinear relationship between PASI and HRQoL (greater relative impact for lower PASI scores) and the larger impact of improvements in PASI on HRQoL of women.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">7</span></a> Female sex, together with PASI, is the strongest determinant of PDI in our setting, and it is well-known that disease of equal severity affects women more than men in terms of its impact on DLQI scores and other HRQoL measures in both psoriasis and other chronic inflammatory diseases.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">8</span></a> This greater impact was not determined in this review.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In the discussion section of their article, the authors mention that the three generic HRQoL questionnaires validated for use in Spain—the 36-item Short-Form Health Survey (SF-36), the EuroQol 5D (EQ-5D), and the Nottingham Health Profile (NHP)–have low sensitivity to clinical change. The most useful of these questionnaires is perhaps EQ-5D,<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">9</span></a> which has different versions that can be used in psoriasis<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">10,11</span></a> and for which algorithms exist to generate utility scores from DLQI scores in patients with psoriasis.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">12</span></a> These scores could be used in pharmacoeconomic studies to define quality-adjusted life years gained with certain therapeutic interventions.</p><p id="par0030" class="elsevierStylePara elsevierViewall">A final point worth noting is the good psychometric properties (internal consistency, reliability, and content and structural validity) observed for CESEPT, the Spanish psoriasis satisfaction treatment questionnaire,<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a> compared with other psoriasis-specific, skin-specific, and generic measures.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-05-08" "fechaAceptado" => "2019-05-13" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Puig L. Patient reported outcomes en psoriasis validados en España: PROs y contras. Actas Dermosifiliogr. 2019;110:519–520.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0075" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Instrumentos para la validación de los resultados percibidos por el paciente con psoriasis en España: revisión sistemática de la literatura" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Lizán" 1 => "C. Gabás-Rivera" 2 => "I. Belinchón" 3 => "T. Dilla" 4 => "T. Huete" 5 => "S. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 13 | 6 | 19 |
| 2024 October | 69 | 39 | 108 |
| 2024 September | 71 | 20 | 91 |
| 2024 August | 98 | 54 | 152 |
| 2024 July | 82 | 28 | 110 |
| 2024 June | 79 | 31 | 110 |
| 2024 May | 86 | 37 | 123 |
| 2024 April | 84 | 20 | 104 |
| 2024 March | 59 | 26 | 85 |
| 2024 February | 53 | 36 | 89 |
| 2024 January | 53 | 34 | 87 |
| 2023 December | 50 | 14 | 64 |
| 2023 November | 61 | 24 | 85 |
| 2023 October | 76 | 23 | 99 |
| 2023 September | 87 | 33 | 120 |
| 2023 August | 46 | 5 | 51 |
| 2023 July | 32 | 37 | 69 |
| 2023 June | 38 | 20 | 58 |
| 2023 May | 101 | 20 | 121 |
| 2023 April | 57 | 17 | 74 |
| 2023 March | 64 | 25 | 89 |
| 2023 February | 53 | 19 | 72 |
| 2023 January | 41 | 20 | 61 |
| 2022 December | 63 | 42 | 105 |
| 2022 November | 34 | 27 | 61 |
| 2022 October | 22 | 14 | 36 |
| 2022 September | 15 | 36 | 51 |
| 2022 August | 36 | 37 | 73 |
| 2022 July | 60 | 34 | 94 |
| 2022 June | 22 | 27 | 49 |
| 2022 May | 26 | 35 | 61 |
| 2022 April | 36 | 31 | 67 |
| 2022 March | 31 | 47 | 78 |
| 2022 February | 21 | 21 | 42 |
| 2022 January | 26 | 28 | 54 |
| 2021 December | 31 | 31 | 62 |
| 2021 November | 36 | 42 | 78 |
| 2021 October | 48 | 55 | 103 |
| 2021 September | 38 | 31 | 69 |
| 2021 August | 22 | 22 | 44 |
| 2021 July | 32 | 31 | 63 |
| 2021 June | 22 | 27 | 49 |
| 2021 May | 23 | 30 | 53 |
| 2021 April | 52 | 45 | 97 |
| 2021 March | 34 | 26 | 60 |
| 2021 February | 43 | 20 | 63 |
| 2021 January | 32 | 12 | 44 |
| 2020 December | 31 | 13 | 44 |
| 2020 November | 20 | 15 | 35 |
| 2020 October | 15 | 2 | 17 |
| 2020 September | 23 | 9 | 32 |
| 2020 August | 36 | 15 | 51 |
| 2020 July | 15 | 15 | 30 |
| 2020 June | 19 | 19 | 38 |
| 2020 May | 15 | 9 | 24 |
| 2020 April | 15 | 8 | 23 |
| 2020 March | 21 | 7 | 28 |
| 2020 February | 4 | 2 | 6 |
| 2019 October | 1 | 0 | 1 |
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