Comparison of patient (POEM), observer (EASI, SASSAD, TIS) and corneometry measures of emollient effectiveness in children with eczema: findings from the COMET feasibility trial

M. J. Ridd, D. M. Gaunt, R. H. Guy, N. M. Redmond, K. Garfield, S. Hollinghurst, N. Ball, L. Shaw, S. Purdy, C. Metcalfe

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Abstract

Background: Eczema affects around 20% of children, but multiple different outcome measures have hampered research into the effectiveness of different treatments. Objectives: To compare the change in scores and correlations within and between five measures of eczema severity: Patient-Orientated Eczema Measure (POEM), Eczema Area and Severity Index (EASI), Six Area, Six Sign Atopic Dermatitis (SASSAD), Three Item Severity (TIS) and skin hydration (corneometry). Methods: Data from a feasibility trial that randomized young children with eczema to one of four emollients were used. Participants were followed for 3 months (84 days). Descriptive statistics (by emollient over time) and Spearman's correlation coefficients comparing scores at each time point and absolute change (between adjacent time points) for each outcome measure were calculated. Results: In total, 197 children, mean ± SD age 21·7 ± 12·8 months, were randomized. POEM and TIS appeared to capture a range of eczema severity at baseline, but only POEM had close approximation to normal distribution. Mean POEM, EASI, SASSAD and TIS scores improved month by month, with POEM showing the greatest sensitivity (effect size 0·42). Correlations within POEM, EASI, SASSAD and TIS were moderate to good, decreasing over time. Correlations between measures were strongest for EASI, SASSAD and TIS. By contrast, corneometry scores were more variable, correlated less well over time and were poorly correlated with the other measures. Conclusions: Except for corneometry, all measures appear to change in relation to emollient use over time and correlate well with themselves. POEM demonstrated the greatest range of scores at baseline and change in eczema severity over the first 28 days.

LanguageEnglish
Pages362-370
Number of pages9
JournalBritish Journal of Dermatology
Volume179
Issue number2
Early online date24 Feb 2018
DOIs
StatusPublished - 1 Aug 2018

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Emollients
Eczema
Atopic Dermatitis
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Dermatology

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Comparison of patient (POEM), observer (EASI, SASSAD, TIS) and corneometry measures of emollient effectiveness in children with eczema : findings from the COMET feasibility trial. / Ridd, M. J.; Gaunt, D. M.; Guy, R. H.; Redmond, N. M.; Garfield, K.; Hollinghurst, S.; Ball, N.; Shaw, L.; Purdy, S.; Metcalfe, C.

In: British Journal of Dermatology, Vol. 179, No. 2, 01.08.2018, p. 362-370.

Research output: Contribution to journalArticle

Ridd, M. J. ; Gaunt, D. M. ; Guy, R. H. ; Redmond, N. M. ; Garfield, K. ; Hollinghurst, S. ; Ball, N. ; Shaw, L. ; Purdy, S. ; Metcalfe, C. / Comparison of patient (POEM), observer (EASI, SASSAD, TIS) and corneometry measures of emollient effectiveness in children with eczema : findings from the COMET feasibility trial. In: British Journal of Dermatology. 2018 ; Vol. 179, No. 2. pp. 362-370.
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abstract = "Background: Eczema affects around 20{\%} of children, but multiple different outcome measures have hampered research into the effectiveness of different treatments. Objectives: To compare the change in scores and correlations within and between five measures of eczema severity: Patient-Orientated Eczema Measure (POEM), Eczema Area and Severity Index (EASI), Six Area, Six Sign Atopic Dermatitis (SASSAD), Three Item Severity (TIS) and skin hydration (corneometry). Methods: Data from a feasibility trial that randomized young children with eczema to one of four emollients were used. Participants were followed for 3 months (84 days). Descriptive statistics (by emollient over time) and Spearman's correlation coefficients comparing scores at each time point and absolute change (between adjacent time points) for each outcome measure were calculated. Results: In total, 197 children, mean ± SD age 21·7 ± 12·8 months, were randomized. POEM and TIS appeared to capture a range of eczema severity at baseline, but only POEM had close approximation to normal distribution. Mean POEM, EASI, SASSAD and TIS scores improved month by month, with POEM showing the greatest sensitivity (effect size 0·42). Correlations within POEM, EASI, SASSAD and TIS were moderate to good, decreasing over time. Correlations between measures were strongest for EASI, SASSAD and TIS. By contrast, corneometry scores were more variable, correlated less well over time and were poorly correlated with the other measures. Conclusions: Except for corneometry, all measures appear to change in relation to emollient use over time and correlate well with themselves. POEM demonstrated the greatest range of scores at baseline and change in eczema severity over the first 28 days.",
author = "Ridd, {M. J.} and Gaunt, {D. M.} and Guy, {R. H.} and Redmond, {N. M.} and K. Garfield and S. Hollinghurst and N. Ball and L. Shaw and S. Purdy and C. Metcalfe",
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T1 - Comparison of patient (POEM), observer (EASI, SASSAD, TIS) and corneometry measures of emollient effectiveness in children with eczema

T2 - British Journal of Dermatology

AU - Ridd, M. J.

AU - Gaunt, D. M.

AU - Guy, R. H.

AU - Redmond, N. M.

AU - Garfield, K.

AU - Hollinghurst, S.

AU - Ball, N.

AU - Shaw, L.

AU - Purdy, S.

AU - Metcalfe, C.

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Background: Eczema affects around 20% of children, but multiple different outcome measures have hampered research into the effectiveness of different treatments. Objectives: To compare the change in scores and correlations within and between five measures of eczema severity: Patient-Orientated Eczema Measure (POEM), Eczema Area and Severity Index (EASI), Six Area, Six Sign Atopic Dermatitis (SASSAD), Three Item Severity (TIS) and skin hydration (corneometry). Methods: Data from a feasibility trial that randomized young children with eczema to one of four emollients were used. Participants were followed for 3 months (84 days). Descriptive statistics (by emollient over time) and Spearman's correlation coefficients comparing scores at each time point and absolute change (between adjacent time points) for each outcome measure were calculated. Results: In total, 197 children, mean ± SD age 21·7 ± 12·8 months, were randomized. POEM and TIS appeared to capture a range of eczema severity at baseline, but only POEM had close approximation to normal distribution. Mean POEM, EASI, SASSAD and TIS scores improved month by month, with POEM showing the greatest sensitivity (effect size 0·42). Correlations within POEM, EASI, SASSAD and TIS were moderate to good, decreasing over time. Correlations between measures were strongest for EASI, SASSAD and TIS. By contrast, corneometry scores were more variable, correlated less well over time and were poorly correlated with the other measures. Conclusions: Except for corneometry, all measures appear to change in relation to emollient use over time and correlate well with themselves. POEM demonstrated the greatest range of scores at baseline and change in eczema severity over the first 28 days.

AB - Background: Eczema affects around 20% of children, but multiple different outcome measures have hampered research into the effectiveness of different treatments. Objectives: To compare the change in scores and correlations within and between five measures of eczema severity: Patient-Orientated Eczema Measure (POEM), Eczema Area and Severity Index (EASI), Six Area, Six Sign Atopic Dermatitis (SASSAD), Three Item Severity (TIS) and skin hydration (corneometry). Methods: Data from a feasibility trial that randomized young children with eczema to one of four emollients were used. Participants were followed for 3 months (84 days). Descriptive statistics (by emollient over time) and Spearman's correlation coefficients comparing scores at each time point and absolute change (between adjacent time points) for each outcome measure were calculated. Results: In total, 197 children, mean ± SD age 21·7 ± 12·8 months, were randomized. POEM and TIS appeared to capture a range of eczema severity at baseline, but only POEM had close approximation to normal distribution. Mean POEM, EASI, SASSAD and TIS scores improved month by month, with POEM showing the greatest sensitivity (effect size 0·42). Correlations within POEM, EASI, SASSAD and TIS were moderate to good, decreasing over time. Correlations between measures were strongest for EASI, SASSAD and TIS. By contrast, corneometry scores were more variable, correlated less well over time and were poorly correlated with the other measures. Conclusions: Except for corneometry, all measures appear to change in relation to emollient use over time and correlate well with themselves. POEM demonstrated the greatest range of scores at baseline and change in eczema severity over the first 28 days.

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DO - 10.1111/bjd.16475

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SP - 362

EP - 370

JO - British Journal of Dermatology

JF - British Journal of Dermatology

SN - 0007-0963

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