Abstract:
Background:
The Eczema Area and Severity Index (EASI) has been suggested to show a good to excellent level of concordance. However, in everyday clinical practice, there is a perceived low level of concordance.
Objective:
To assess the degree of concordance in the EASI scores in a real-world clinical setting.
Methods:
This transversal study assesses interobserver concordance of EASI among 5 evaluators between January and October 2024.
Results:
For the head and neck area, unacceptable concordance was found for all the items in EASI. In the trunk area, there was acceptable concordance for the affected surface area (0.686 [95% confidence interval {CI}: 0.539–0.799]) but unacceptable concordance for the other items. For the upper and lower extremities, unacceptable concordance was observed for all items. The total EASI interclass correlation coefficient showed moderate concordance (0.754 [95% CI: 0.659–0.838]). Despite moderate concordance for the total EASI score, the median EASI range for the same patient was 13, indicating significant heterogeneity between evaluators.
Discussion and Conclusion:
This study highlights the variability of the EASI in the evaluation of atopic dermatitis (AD) in a real-world clinical practice setting, suggesting that patient-reported outcome measures and experiences should be given more importance as additional AD severity measures.
Supplementary Material
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