Introduction
Methods
Study design and patient population
Health-related quality of life measures
EQ-5D-3L and EQ-5D-5L
Dermatology Life Quality Index (DLQI)
Skindex-16
Statistical analyses
Feasibility and ceiling effects
Agreement
Redistribution properties
Informativity
Convergent and validity
Known-groups validity
Results
Patient characteristics
Variables | Mean (SD) or N (%) |
---|---|
Age (years) | 37.13 (12.43) |
Sex | |
Female | 77 (38.5%) |
Male | 123 (61.5%) |
Disease duration (years) | 4.76 (6.72) |
Disease severity | |
Hurley staging (missing n = 4) | |
Hurley I | 22 (11.2%) |
Hurley II | 79 (40.3%) |
Hurley III | 95 (48.5%) |
HS-PGA (missing n = 7) | |
Clear | 6 (3.1%) |
Minimal | 7 (3.6%) |
Mild | 37 (19.3%) |
Moderate | 69 (35.9%) |
Severe | 40 (20.7%) |
Very severe | 34 (17.7%) |
Modified Sartorius Scorea (missing n = 2) | 60.69 (50.24) |
PtGA VAS (0-100) (missing n = 1) | 69.62 (22.22) |
Current pain intensity VAS (0–10) (missing n= 1) | 4.70 (2.99) |
Worst pain intensityb VAS (0–10) (missing n= 1) | 6.28 (3.04) |
Health-related quality of life | |
EQ-5D-3L index (− 0.865 to 1) (missing n = 2) | 0.78 (0.21) |
EQ-5D-5L index (− 0.848 to 1) (missing n = 2) | 0.76 (0.30) |
EQ VAS (0–100) (missing n = 2) | 64.29 (22.68) |
DLQI (0–30) (missing n = 2) | 11.75 (8.11) |
Skindex-16 (missing n = 2) | |
Symptoms subscale (0–100) | 46.74 (29.36) |
Emotions subscale (0–100) | 64.55 (29.28) |
Functioning subscale (0–100) | 49.40 (34.70) |
Feasibility
Ceiling effects
Dimensions | Ceiling effects | Inconsistencies | Informativity | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
EQ-5D-3L | EQ-5D-5L | Ceiling effect reduction | McNemar’s test p value | EQ-5D-3L | EQ-5D-5L | ||||||||
n | Ceiling, n, % | n | Ceiling, n, % | Absolute | Relative (%) | Inconsistent response pairs (n, %)a | Average size of inconsistencies | H' | J' | H' | J' | ||
Mobility | 199 | 121 (60.8%) | 199 | 107 (53.8%) | 7.0% | 11.6% | 0.003 | 7 (3.5%) | 1.14 | 0.93 | 0.59 | 1.65 | 0.71 |
Self-care | 200 | 161 (80.5%) | 198 | 142 (71.7%) | 8.8% | 11.8% | < 0.001 | 7 (3.5%) | 1.14 | 0.71 | 0.45 | 1.25 | 0.54 |
Usual activities | 200 | 103 (51.5%) | 198 | 87 (43.9%) | 7.6% | 15.5% | 0.024 | 20 (10.0%) | 1.00 | 1.22 | 0.77 | 1.88 | 0.81 |
Pain/discomfort | 199 | 49 (24.6%) | 199 | 45 (22.6%) | 2.0% | 8.2% | 0.503 | 15 (7.5%) | 1.00 | 1.32 | 0.83 | 2.06 | 0.89 |
Anxiety/depression | 199 | 88 (44.2%) | 199 | 98 (49.2%) | -5.0% | -11.4% | 0.163 | 30 (15.1%) | 1.20 | 1.38 | 0.87 | 1.79 | 0.77 |
Overall (11111) or mean | 200 | 32 (16.0%) | 199 | 29 (14.6%) | 1.40% | 9.38% | 0.607 | 79 (8.0%) | 1.10 | 1.11 | 0.70 | 1.73 | 0.74 |
Agreement
Redistribution properties and inconsistencies
3L | 5L | ||||
---|---|---|---|---|---|
Dimensions | Level 1 | Level 2 | Level 3 | Level 4 | Level 5 |
Mobility, n (%) | |||||
Level 1 | 104 (86.0%) | 13 (10.7%) | 3 (2.5%) | 1 (0.8%) | 0 (0.0%) |
Level 2 | 3 (3.9%) | 28 (36.8%) | 36 (47.4%) | 9 (11.8%) | 0 (0.0%) |
Level 3 | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 1 (100.0%) | 0 (0.0%) |
Self-care, n (%) | |||||
Level 1 | 141 (88.1%) | 13 (8.1%) | 5 (3.1%) | 1 (0.6%) | 0 (0.0%) |
Level 2 | 1 (2.6%) | 16 (42.1%) | 15 (39.5%) | 6 (15.8%) | 0 (0.0%) |
Level 3 | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
Usual activities, n (%) | |||||
Level 1 | 75 (73.5%) | 22 (21.6%) | 5 (4.9%) | 0 (0.0%) | 0 (0.0%) |
Level 2 | 12 (13.6%) | 35 (39.8%) | 25 (28.4%) | 15 (17.0%) | 1 (1.1%) |
Level 3 | 0 (0.0%) | 0 (0.0%) | 2 (25.0%) | 4 (50.0%) | 2 (25.0%) |
Pain/discomfort, n (%) | |||||
Level 1 | 37 (75.5%) | 9 (18.4%) | 3 (6.1%) | 0 (0.0%) | 0 (0.0%) |
Level 2 | 8 (6.6%) | 58 (47.5%) | 49 (40.2%) | 7 (5.7%) | 0 (0.0%) |
Level 3 | 0 (0.0%) | 0 (0.0%) | 4 (14.8%) | 16 (59.3%) | 7 (25.9%) |
Anxiety/depression, n (%) | |||||
Level 1 | 76 (86.4%) | 12 (13.6%) | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) |
Level 2 | 20 (22.5%) | 38 (42.7%) | 25 (28.1%) | 6 (6.7%) | 0 (0.0%) |
Level 3 | 1 (4.8%) | 4 (19.0%) | 5 (23.8%) | 7 (33.3%) | 4 (19.0%) |
Informativity
Convergent validity
Outcome measures | EQ-5D | ||||||
---|---|---|---|---|---|---|---|
Version | Mobility | Self-care | Usual activities | Pain/discomfort | Anxiety/depression | Index score | |
EQ VAS (0-100) | 3L | − 0.406 | − 0.365 | − 0.350 | − 0.414 | − 0.449 | 0.535 |
5L | − 0.473 | − 0.399 | − 0.422 | − 0.505 | − 0.385 | 0.592 | |
Skindex-16 symptoms (0-100) | 3L | 0.331 | 0.287 | 0.420 | 0.523 | 0.422 | − 0.561 |
5L | 0.396 | 0.334 | 0.396 | 0.595 | 0.401 | − 0.573 | |
Skindex-16 emotions (0-100) | 3L | 0.261 | 0.274 | 0.358 | 0.471 | 0.513 | − 0.535 |
5L | 0.289 | 0.282 | 0.302 | 0.473 | 0.511 | − 0.500 | |
Skindex-16 functioning (0-100) | 3L | 0.403 | 0.434 | 0.538 | 0.610 | 0.566 | − 0.708 |
5L | 0.467 | 0.457 | 0.501 | 0.625 | 0.530 | − 0.674 | |
DLQI (0-30) | 3L | 0.396 | 0.409 | 0.547 | 0.628 | 0.564 | − 0.722 |
5L | 0.426 | 0.469 | 0.541 | 0.671 | 0.560 | − 0.697 | |
PtGA VAS (0-100) | 3L | 0.264 | 0.334 | 0.316 | 0.337 | 0.296 | − 0.395 |
5L | 0.340 | 0.347 | 0.363 | 0.391 | 0.315 | − 0.434 | |
HS-PGA (0-5) | 3L | 0.291 | 0.348 | 0.371 | 0.230 | 0.205 | − 0.337 |
5L | 0.349 | 0.343 | 0.354 | 0.290 | 0.173 | − 0.350 | |
Modified Sartorius Score (0-)a | 3L | 0.266 | 0.335 | 0.319 | 0.243 | 0.212 | − 0.332 |
5L | 0.325 | 0.301 | 0.333 | 0.302 | 0.166 | − 0.334 | |
Current pain intensity (0–10) | 3L | 0.286 | 0.306 | 0.314 | 0.534 | 0.374 | − 0.540 |
5L | 0.384 | 0.310 | 0.337 | 0.591 | 0.315 | − 0.544 | |
Worst average pain in the past 1 month (0–10) | 3L | 0.315 | 0.328 | 0.368 | 0.553 | 0.263 | − 0.499 |
5L | 0.328 | 0.299 | 0.353 | 0.529 | 0.285 | − 0.473 |
Known-groups validity
EQ-5D-5L | EQ-5D-3L | REb | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
n | Mean (SD) | Median (Q1-Q3) | p valuea | ES | n | Mean (SD) | Median (Q1–Q3) | p valuea | ES | ||
Total sample | 198 | 0.76 (0.30) | 0.86 (0.71–0.96) | – | – | 198 | 0.78 (0.21) | 0.82 (0.75–0.90) | – | – | – |
Body mass index (BMI) (missing n = 3) | |||||||||||
Normal or underweight (< 24.9) | 38 | 0.81 (0.20) | 0.86 (0.76–0.93) | 0.235 | 0.005 | 38 | 0.81 (0.14) | 0.81 (0.78–0.90) | 0.046 | 0.022 | 0.216 |
Overweight (25.0–29.9) | 65 | 0.78 (0.28) | 0.89 (0.71–0.96) | 65 | 0.83 (0.21) | 0.88 (0.79–0.98) | |||||
Obese (≥ 30) | 92 | 0.72 (0.33) | 0.85 (0.64–0.96) | 92 | 0.75 (0.22) | 0.82 (0.60–0.90) | |||||
Comorbidities | |||||||||||
None | 106 | 0.79 (0.27) | 0.89 (0.75–0.96) | 0.003 | 0.050 | 106 | 0.81 (0.17) | 0.85 (0.78–0.90) | 0.160 | 0.032 | 1.539 |
1 | 55 | 0.80 (0.22) | 0.86 (0.76–0.96) | 55 | 0.82 (0.15) | 0.82 (0.78–0.90) | |||||
≥ 2 | 37 | 0.59 (0.41) | 0.74 (0.39–0.88) | 37 | 0.64 (0.31) | 0.80 (0.36–0.88) | |||||
Hurley staging (missing n = 4) | |||||||||||
Hurley I | 22 | 0.83 (0.23) | 0.89 (0.77–0.97) | 0.001 | 0.068 | 22 | 0.83 (0.18) | 0.89 (0.78–0.93) | < 0.001 | 0.071 | 0.960 |
Hurley II | 79 | 0.83 (0.21) | 0.92 (0.76–0.96) | 79 | 0.83 (0.17) | 0.88 (0.80–0.90) | |||||
Hurley III | 93 | 0.67 (0.35) | 0.80 (0.57-0.92) | 93 | 0.73 (0.24) | 0.80 (0.64–0.88) | |||||
HS-PGA (missing n = 7) | |||||||||||
Clear-minimal | 13 | 0.91 (0.12) | 1.00 (0.83–1.00) | < 0.001 | 0.116 | 13 | 0.90 (0.14) | 1.00 (0.81–1.00) | < 0.001 | 0.112 | 1.036 |
Mild | 37 | 0.85 (0.17) | 0.92 (0.81–0.96) | 37 | 0.84 (0.15) | 0.82 (0.80–0.90) | |||||
Moderate | 69 | 0.79 (0.27) | 0.88 (0.75–0.96) | 69 | 0.80 (0.19) | 0.85 (0.79–0.90) | |||||
Severe | 40 | 0.73 (0.31) | 0.81 (0.69–0.92) | 39 | 0.79 (0.16) | 0.82 (0.72–0.90) | |||||
Very severe | 32 | 0.53 (0.40) | 0.64 (0.20–0.86) | 33 | 0.62 (0.30) | 0.72 (0.42–0.81) | |||||
Localisation | |||||||||||
Axillary | |||||||||||
No | 44 | 0.78 (0.25) | 0.85 (0.73–0.92) | 0.771 | 0.000 | 43 | 0.80 (0.17) | 0.80 (0.78–0.90) | 0.850 | 0.000 | 2.371 |
Yes | 154 | 0.75 (0.31) | 0.87 (0.71–0.96) | 155 | 0.78 (0.22) | 0.82 (0.75–0.90) | |||||
Genital | |||||||||||
No | 147 | 0.77 (0.29) | 0.88 (0.75–0.96) | 0.079 | 0.016 | 147 | 0.79 (0.19) | 0.82 (0.75–0.90) | 0.491 | 0.002 | 6.518 |
Yes | 51 | 0.71 (0.33) | 0.80 (0.60–0.92) | 51 | 0.76 (0.26) | 0.82 (0.72–0.90) | |||||
Gluteal | |||||||||||
No | 140 | 0.80 (0.25) | 0.88 (0.75–0.96) | < 0.001 | 0.061 | 141 | 0.82 (0.16) | 0.85 (0.80–0.90) | < 0.001 | 0.062 | 0.986 |
Yes | 58 | 0.64 (0.36) | 0.77 (0.37–0.90) | 57 | 0.68 (0.28) | 0.78 (0.54–0.90) | |||||
Inguinal | |||||||||||
No | 72 | 0.85 (0.18) | 0.89 (0.79–0.96) | 0.004 | 0.041 | 72 | 0.84 (0.14) | 0.86 (0.80–0.90) | 0.013 | 0.031 | 1.314 |
Yes | 126 | 0.70 (0.34) | 0.84 (0.60–0.96) | 126 | 0.75 (0.23) | 0.82 (0.64–0.90) | |||||
Perianal | |||||||||||
No | 176 | 0.76 (0.30) | 0.87 (0.71–0.96) | 0.509 | 0.002 | 176 | 0.79 (0.19) | 0.82 (0.78–0.90) | 0.140 | 0.011 | 0.200 |
Yes | 22 | 0.73 (0.32) | 0.85 (0.70–0.90) | 22 | 0.70 (0.31) | 0.79 (0.58–0.88) | |||||
Submammary | |||||||||||
No | 174 | 0.77 (0.28) | 0.87 (0.71–0.96) | 0.655 | 0.001 | 174 | 0.79 (0.19) | 0.82 (0.77–0.90) | 0.746 | 0.001 | 1.903 |
Yes | 24 | 0.68 (0.42) | 0.82 (0.66–0.96) | 24 | 0.71 (0.33) | 0.82 (0.60–0.90) |