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Frequency and influence of “not relevant” responses on the Dermatology Life Quality Index among adults with atopic dermatitis

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Abstract

Purpose

“Not relevant” responses (NRRs) on the Dermatology Life Quality Index (DLQI) are common among adults with psoriasis and may be associated with underestimation of disease burden. Little is known about “not relevant” responses among adults with atopic dermatitis. We aimed to examine the frequency of NRRs on the DLQI and to determine whether NRRs are associated with underestimation of disease burden among adults with atopic dermatitis.

Methods

Adults with atopic dermatitis were identified and evaluated via online survey. We evaluated the frequency of NRRs on the DLQI, stratified by sociodemographic characteristics. To examine the association between NRRs and other measures of disease burden, Patient-Oriented Eczema Measure (POEM), Patient-Oriented SCORAD (PO-SCORAD), and Short-Form (SF)-12 scores were compared between those who responded “not relevant” versus “not at all”.

Results

Among 764 adults with atopic dermatitis, most had mild disease. The median (interquartile range [IQR]) POEM, PO-SCORAD, and DLQI scores were 5 (2–10), 24 (14–34), and 2 (1–6), respectively. Most (55.2%) also had at least one NRR, and 17.9% had 4 or more “not relevant” responses, with differences across several sociodemographic characteristics. There were no substantial differences in SF-12, POEM, and PO-SCORAD scores between those who responded “not relevant” versus “not at all”.

Conclusion

NRRs on the DLQI are common among adults with atopic dermatitis and differ across sociodemographic characteristics, suggesting issues with content validity. There is not a clear association between NRRs and other measures of disease severity among adults with mostly mild atopic dermatitis.

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Funding

Dr. Barbieri is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under award number T32-AR-007465 and receives partial salary support through a Pfizer Fellowship in Dermatology Patient Oriented Research grant to the Trustees of the University of Pennsylvania. Dr. Takeshita is supported by NIAMS K23-AR068433. Dr. Chiesa Fuxench is supported by a Career Development Award through the Dermatology Foundation for work related to atopic dermatitis. Role of the Funder/Sponsor: The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA

    John S. Barbieri, Zelma C. Chiesa Fuxench, Daniel B. Shin & Junko Takeshita

  2. Department of Biostatistics, Epidemiology and Informatics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA

    Junko Takeshita

  3. Perelman Center for Advanced Medicine, 7th Floor, South Tower, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA

    John S. Barbieri

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  1. John S. Barbieri
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Correspondence to John S. Barbieri.

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Conflict of interest

Dr. Takeshita receives a research grant from Pfizer Inc (to the Trustees of the University of Pennsylvania) for work that is unrelated to this study and has received payment for continuing medical education work related to psoriasis that was supported indirectly by Eli Lilly. Dr. Chiesa Fuxench has served as a consultant for the National Eczema Association, Asthma and Allergy Foundation, Sanofi, Pfizer, and AbbVie receiving honoraria, and receives or has received research grants (to the Trustees of the University of Pennsylvania) from Regeneron, Sanofi, Leo, Menlo Therapeutics, Tioga and Vanda pharmaceuticals for clinical trials related to atopic dermatitis; and has received payment for continuing medical education work related to atopic dermatitis that was supported indirectly by Sanofi and Regeneron.

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This study was deemed exempt by the University of Pennsylvania Institutional Review Board.

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Barbieri, J.S., Chiesa Fuxench, Z.C., Shin, D.B. et al. Frequency and influence of “not relevant” responses on the Dermatology Life Quality Index among adults with atopic dermatitis. Qual Life Res 30, 1705–1713 (2021). https://doi.org/10.1007/s11136-021-02770-z

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