A Prospective Cross-Sectional Analysis of Construct Validity for the PALMPASS,A Brief Patient-Reported Outcome Measure for Psoriasis

Abstract

Background:

While the Psoriasis Area and Severity Index (PASI) represents the most commonly used assessment tool for psoriasis severity, it has been criticized for its complexity in clinical practice.

Objective:

To validate a simplified 2-item patient-administered limited measure psoriasis area and severity score (PALMPASS) compared to standardized measure of psoriasis.

Materials and Methods:

This was a prospective observational survey of adult patients with psoriasis and psoriatic arthritis in Veterans Affairs Medical Center (VAMC) dermatology and rheumatology clinics participating in the Program to Understand the Longterm outcomes in SpondyloARthritis registry between January and June 2016 (n = 885). Patients at 7 US VAMCs (n = 363) completed a 2-item, 11-point PALMPASS questionnaire, assessing (1) how psoriasis affected the patient and (2) the degree of surface area involvement. Results from the PALMPASS were then compared to the PASI, the Psoriasis Symptom Inventory (PSI) and the Dermatology Life Quality Index (DLQI). Data were analyzed using Lin concordance, intraclass correlations, Spearman correlations, and linear regression.

Results:

Strong correlations existed between PALMPASS and PASI (Spearman ρ = 0.74, P < .001), PSI (Spearman ρ = 0.71, P = .001), and DLQI (Spearman ρ = 0.77, P < .001). Results were comparable in analyses based on intraclass correlations. Elevated C-reactive protein concentrations correlated with higher PALMPASS.

Conclusion:

The PALMPASS is a patient-reported instrument that demonstrates validity and serves as a reliable and simplified tool to guide evidence-based management.

Keywords

psoriasis psoriatic arthritis severity index quality of life therapeutics

Get full access to this article

View all access options for this article.

References

Rachakonda

Schupp

Armstrong

. Psoriasis prevalence among adults in the United States. J Am Acad Dermatol. 2014;70(3):512–516.

Gottlieb

Greb

Goldminz

. Psoriasis trends and practice gaps. Dermatol Clin. 2016;34(3):235–242.

Langley

Ellis

. Evaluating psoriasis with psoriasis area and severity index, psoriasis global assessment, and lattice system physician’s global assessment. J Am Acad Dermatol. 2004;51(4):563–569.

Berth-Jones

Grotzinger

Rainville

, et al. A study examining inter- and intrarater reliability of three scales for measuring severity of psoriasis: Psoriasis area and severity index, physician’s global assessment and lattice system physician’s global assessment. Br J Dermatol. 2006;155(4):707–713.

Simpson

Chow

Morgenstern

Luger

Ellis

. Comparison of three methods for measuring psoriasis severity in clinical studies (Part 2 of 2): use of quality of life to assess construct validity of the Lattice System Physician’s Global Assessment, Psoriasis Area and Severity Index and Static Physician’s Global Assessment. J Eur Acad Dermatol Venereol. 2015;29(7):1415–1420.

Chow

Simpson

Luger

Chubb

Ellis

. Comparison of three methods for measuring psoriasis severity in clinical studies (Part 1 of 2): change during therapy in Psoriasis area and severity index, static physician’s global assessment and lattice system physician’s global assessment. J Eur Acad Dermatol Venereol. 2015;29(7):1406–1414.

Dandorfer

Rech

Manger

Schett

Englbrecht

. Differences in the patient’s and the physician’s perspective of disease in psoriatic arthritis. Semin Arthritis Rheum. 2012;42(1):32–41.

Szepietowski

Reich

. Pruritus in psoriasis: an update. Eur J Pain. 2016;20(1):41–46.

Puzenat

Bronsard

Prey

, et al. What are the best outcome measures for assessing plaque psoriasis severity? A systematic review of the literature. J Eur Acad Dermatol Venereol. 2010;24(suppl 2):10–16. doi:10.1111/j.1468-3083.2009.03562.x.

10.

Carlin

Feldman

Krueger

Menter

Krueger

. A 50% reduction in the Psoriasis Area and Severity Score (PASI 50) is a clinically significant endpoint in the assessment of psoriasis. J Am Acad Dermatol. 2004;50(6):859–866.

11.

Wilson

Mutebi

Revicki

, et al. Reliability and validity of the psoriasis symptom inventory in patients with psoriatic arthritis. Arthritis Care Res (Hoboken). 2015;67(12):1750–1756. doi:10.1002/acr.22653.

12.

Basra

Fenech

Gatt

Salek

Finlay

. The Dermatology Life Quality Index 1994-2007: a comprehensive review of validation data and clinical results. Br J Dermatol. 2008;159(5):997–1035. doi:10.1111/j.1365-2133.2008.08832.x.

13.

Lin

. A concordance correlation coefficient to evaluate reproducibility. Biometrics. 1989;45(1):255–268.

14.

Walsh

McFadden

Woodcock

, et al. Product of the Physician Global Assessment and body surface area: a simple static measure of psoriasis severity in a longitudinal cohort. J Am Acad Dermatol. 2013;69(6):931–937.

15.

van de Kerkhof

Reich

Kavanaugh

, et al. Physician perspectives in the management of psoriasis and psoriatic arthritis: results from the population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis survey. J Eur Acad Dermatol Venereol. 2015;29(10):2002–2010.

16.

Lebwohl

Bachelez

Barker

, et al. Patient perspectives in the management of psoriasis: results from the population-based Multinational Assessment of Psoriasis and Psoriatic Arthritis Survey. J Am Acad Dermatol. 2014;70(5):871–881.e1–30.

17.

Vadakayil

Dandekeri

Kambil

Ali

. Role of C-reactive protein as a marker of disease severity and cardiovascular risk in patients with psoriasis. Indian Dermatol Online J. 2015;6(5):322–325.

18.

Asahina

Umezawa

Yanaba

Nakagawa

Serum C-reactive protein levels in Japanese patients with psoriasis and psoriatic arthritis: long-term differential effects of biologics. J Dermatol. 2016;43(7):779–784.

19.

Solak

Dikicier

Erdem

. Impact of elevated serum uric acid levels on systemic inflammation in patients with psoriasis. Angiology. 2017;68(3):266–270. doi:10.1177/0003319716657980.

20.

Helmick

Lee-Han

Hirsch

Baird

Bartlett

. Prevalence of psoriasis among adults in the U.S.: 2003-2006 and 2009-2010 national health and nutrition examination surveys. Am J Prev Med. 2014;47(1):37–45.

21.

Nas

Capkin

Dagli

, et al. Gender specific differences in patients with psoriatic arthritis. Mod Rheumatol. 2017;27(2):345–349.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.23 MB

0.21 MB

0.19 MB

0.20 MB

0.04 MB

0.17 MB