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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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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 13 | 6 | 19 |
| 2024 Octubre | 69 | 39 | 108 |
| 2024 Septiembre | 71 | 20 | 91 |
| 2024 Agosto | 98 | 54 | 152 |
| 2024 Julio | 82 | 28 | 110 |
| 2024 Junio | 79 | 31 | 110 |
| 2024 Mayo | 86 | 37 | 123 |
| 2024 Abril | 84 | 20 | 104 |
| 2024 Marzo | 59 | 26 | 85 |
| 2024 Febrero | 53 | 36 | 89 |
| 2024 Enero | 53 | 34 | 87 |
| 2023 Diciembre | 50 | 14 | 64 |
| 2023 Noviembre | 61 | 24 | 85 |
| 2023 Octubre | 76 | 23 | 99 |
| 2023 Septiembre | 87 | 33 | 120 |
| 2023 Agosto | 46 | 5 | 51 |
| 2023 Julio | 32 | 37 | 69 |
| 2023 Junio | 38 | 20 | 58 |
| 2023 Mayo | 101 | 20 | 121 |
| 2023 Abril | 57 | 17 | 74 |
| 2023 Marzo | 64 | 25 | 89 |
| 2023 Febrero | 53 | 19 | 72 |
| 2023 Enero | 41 | 20 | 61 |
| 2022 Diciembre | 63 | 42 | 105 |
| 2022 Noviembre | 34 | 27 | 61 |
| 2022 Octubre | 22 | 14 | 36 |
| 2022 Septiembre | 15 | 36 | 51 |
| 2022 Agosto | 36 | 37 | 73 |
| 2022 Julio | 60 | 34 | 94 |
| 2022 Junio | 22 | 27 | 49 |
| 2022 Mayo | 26 | 35 | 61 |
| 2022 Abril | 36 | 31 | 67 |
| 2022 Marzo | 31 | 47 | 78 |
| 2022 Febrero | 21 | 21 | 42 |
| 2022 Enero | 26 | 28 | 54 |
| 2021 Diciembre | 31 | 31 | 62 |
| 2021 Noviembre | 36 | 42 | 78 |
| 2021 Octubre | 48 | 55 | 103 |
| 2021 Septiembre | 38 | 31 | 69 |
| 2021 Agosto | 22 | 22 | 44 |
| 2021 Julio | 32 | 31 | 63 |
| 2021 Junio | 22 | 27 | 49 |
| 2021 Mayo | 23 | 30 | 53 |
| 2021 Abril | 52 | 45 | 97 |
| 2021 Marzo | 34 | 26 | 60 |
| 2021 Febrero | 43 | 20 | 63 |
| 2021 Enero | 32 | 12 | 44 |
| 2020 Diciembre | 31 | 13 | 44 |
| 2020 Noviembre | 20 | 15 | 35 |
| 2020 Octubre | 15 | 2 | 17 |
| 2020 Septiembre | 23 | 9 | 32 |
| 2020 Agosto | 36 | 15 | 51 |
| 2020 Julio | 15 | 15 | 30 |
| 2020 Junio | 19 | 19 | 38 |
| 2020 Mayo | 15 | 9 | 24 |
| 2020 Abril | 15 | 8 | 23 |
| 2020 Marzo | 21 | 7 | 28 |
| 2020 Febrero | 4 | 2 | 6 |
| 2019 Octubre | 1 | 0 | 1 |
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