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Response shift in severity assessment of hand eczema with visual analogue scales

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Authors:
  • Mollerup, Annette ;
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    unknown
  • Johansen, Jeanne D
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    Department of Clinical Medicine, Department of Clinical Medicine, Faculty of Health and Medical Sciences, Københavns Universitet
DOI:
10.1111/cod.12335
Abstract:
BACKGROUND: Hand eczema is a common and fluctuating disease. Visual analogue scales (VASs) are used to assess disease severity, both currently and when at its worst. However, such patient-reported outcomes may be at risk of being flawed owing to recall bias or response shifts. OBJECTIVE: To explore whether the current state of hand eczema severity affects the recollection of the eczema when at its worst, thus resulting in a response shift. METHODS: We utilized a dataset from a recent clinical trial examining nurse counselling of hand eczema patients. The patients assessed the disease severity currently (VASnow ) and when at its worst (VASworst ), both at baseline and at a 6-month follow-up. RESULTS: The patients who reported improvement during the course were generally more likely to downwardly adjust their assessment of VASworst than patients reporting unchanged or worsened severity (odds ratio 1.94, p = 0.017). No other determinants were found. CONCLUSION: Patients may downwardly adjust their assessment of worst-ever disease severity according to the assessment of present disease severity. Regular photographic documentation of the hand eczema along with the patient's self-monitoring of symptoms as part of the treatment course could perhaps counteract this tendency for there to be severity habituation.
Type:
Journal article
Language:
English
Published in:
Contact Dermatitis, 2015, Vol 72, Issue 3, p. 178-83
Keywords:
Adolescent; Adult; Aged; Diagnostic Self Evaluation; Eczema; Female; Hand Dermatoses; Humans; Male; Middle Aged; Severity of Illness Index; Visual Analog Scale; Young Adult; Journal Article; Research Support, Non-U.S. Gov't
Main Research Area:
Medical science
Publication Status:
Published
Review type:
Peer Review
Submission year:
2015
Scientific Level:
Scientific
ID:
274386993

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