Abstract
Health outcomes can be captured and reported from a number of perspectives, and the patient’s perspective is central to successful healthcare delivery and optimizing health outcomes. A patient-centered approach is important in dermatology. We discussed the meaning and application of “patient centeredness,” “patient-centered outcome measures (PCOM),” and “patient-reported outcomes (PROs)” in dermatology. We highlighted the important roles that organizations such as the Patient-Centered Outcomes Research Institute (PCORI) and the International Dermatology Outcome Measures (IDEOM) play in advancing patient centeredness in skin diseases. We examined classic patient-reported outcome measures such as the Dermatology Life Quality Index (DLQI) and the Skindex. We also explored patient-centered outcomes in dermatologic surgery. With the development of patient-centered outcome measures, patients are able to express how their skin disease affects their lives in a systematic and valid fashion. These responses are highly valuable in guiding clinical decision-making and improving all aspects of patients’ well-being.
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Frez ML, Asawanonda P, Gunasekara C, Koh C, Loo S, Oon HH, et al. Recommendations for a patient-centered approach to the assessment and treatment of scalp psoriasis: a consensus statement from the Asia Scalp Psoriasis Study Group. J Dermatol Treat. 2014;25(1):38–45.
Chambers CJ, Parsi KK, Schupp C, Armstrong AW. Patient-centered online management of psoriasis: a randomized controlled equivalency trial. J Am Acad Dermatol. 2012;66(6):948–53.
Parsi K, Chambers CJ, Armstrong AW. Cost-effectiveness analysis of a patient-centered care model for management of psoriasis. J Am Acad Dermatol. 2012;66(4):563–70. This paper represents the progression of patient-centered outcomes research. In it, the economics of a patient-centered care model for psoriasis management are evaluated, providing data guide pragmatic future models.
Selby JV, Lipstein SH. PCORI at 3 years—progress, lessons, and plans. N Engl J Med. 2014;370(7):592–5.
Methodological standards and patient-centeredness in comparative effectiveness research: the PCORI perspective. JAMA. 2012;307(15):1636–40.
Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210–6.
Finlay AY, Basra MK, Piguet V, Salek MS. Dermatology life quality index (DLQI): a paradigm shift to patient-centered outcomes. J Investig Dermatol. 2012;132(10):2464–5.
Clancy C, Collins FS. Patient-Centered Outcomes Research Institute: the intersection of science and health care. Sci Transl Med. 2010;2(37):37cm18.
Selby JV, Beal AC, Frank L. The Patient-Centered Outcomes Research Institute (PCORI) national priorities for research and initial research agenda. JAMA. 2012;307(15):1583–4.
Fleurence RL, Curtis LH, Califf RM, Platt R, Selby JV, Brown JS. Launching PCORnet, a national patient-centered clinical research network. J Am Med Inform Assoc. 2014;21(4):578–82.
Gottlieb AB, Armstrong AW, Christensen R, Garg A, Duffin KC, Boehncke WH, et al. The International Dermatology Outcome Measures initiative as applied to psoriatic disease outcomes: a report from the GRAPPA 2013 meeting. J Rheumatol. 2014;41(6):1227–9. The GRAPPA 2013 represents the first, large-scale commitment by the dermatology community to explore and advance patient-centered outcomes research. This meeting also reviewed the efficacy of standing patient-centered outcomes and established routes for growth.
Boers M, Tugwell P. OMERACT conference questionnaire results. OMERACT Committee. J Rheumatol. 1993;20(3):552–4.
Fried BJ, Boers M, Baker PR. A method for achieving consensus on rheumatoid arthritis outcome measures: the OMERACT conference process. J Rheumatol. 1993;20(3):548–51.
Tugwell P, Boers M. Developing consensus on preliminary core efficacy endpoints for rheumatoid arthritis clinical trials. OMERACT Committee. J Rheumatol. 1993;20(3):555–6.
Lewis V, Finlay AY. 10 years experience of the Dermatology Life Quality Index (DLQI). J Investig Dermatol Symp Proc. 2004;9(2):169–80.
Nijsten T. Dermatology life quality index: time to move forward. J Investig Dermatol. 2012;132(1):11–3. This paper evaluates the Dermatology Life Quality Index, one of the most widely used patient-centered outcome measures in dermatology. The paper comments on the strength of the index, as well as potential shortcomings that must be addressed in future outcome measures.
Twiss J, Meads DM, Preston EP, Crawford SR, McKenna SP. Can we rely on the Dermatology Life Quality Index as a measure of the impact of psoriasis or atopic dermatitis? J Investig Dermatol. 2012;132(1):76–84.
Chren MM, Lasek RJ, Quinn LM, Mostow EN, Zyzanski SJ. Skindex, a quality-of-life measure for patients with skin disease: reliability, validity, and responsiveness. J Investig Dermatol. 1996;107(5):707–13.
Chren MM. The Skindex instruments to measure the effects of skin disease on quality of life. Dermatol Clin. 2012;30(2):231–6. xiii.
Chren MM, Lasek RJ, Sahay AP, Sands LP. Measurement properties of Skindex-16: a brief quality-of-life measure for patients with skin diseases. J Cutan Med Surg. 2001;5(2):105–10.
Fernandez-Penas P, Jones-Caballero M, Espallardo O, Garcia-Diez A. Comparison of Skindex-29, Dermatology Life Quality Index, Psoriasis Disability Index and Medical Outcome Study Short Form 36 in patients with mild to severe psoriasis. Br J Dermatol. 2012;166(4):884–7.
Sharon VR, Armstrong AW, Jim On SC, Ibrahimi OA, Eisen DB. Separate- versus same-day preoperative consultation in dermatologic surgery: a patient-centered investigation in an academic practice. Dermatol Surg. 2013;39(2):240–7.
Sharon VR, Armstrong AW, Jim-On S, Ibrahimi OA, Eisen DB. Postoperative preferences in cutaneous surgery: a patient-centered investigation from an academic dermatologic surgery practice. Dermatol Surg. 2013;39(5):773–8.
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TS Okland declares no conflicts of interest.
AW Armstrong serves as investigator and/or consultant to AbbVie, Amgen, Janssen, Merck, Lily, Celgene, Novartis, UCB, Pfizer, and Modernizing Medicine.
Human and Animal Rights and Informed Consent
All studies by AW Armstrong involving animal and/or human subjects were performed after approval by the appropriate institutional review boards. When required, written informed consent was obtained from all participants.
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This article is part of the Topical Collection on Epidemiology
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Okland, T.S., Armstrong, A.W. Patient-Centered Outcomes in Dermatology. Curr Derm Rep 4, 15–19 (2015). https://doi.org/10.1007/s13671-014-0096-8
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DOI: https://doi.org/10.1007/s13671-014-0096-8