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Meeting ReportAnnual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), Stockholm, Sweden, June 26–27, 2012

Psoriasis Outcome Measures: A Report from the GRAPPA 2012 Annual Meeting

Alice B. Gottlieb and April W. Armstrong
The Journal of Rheumatology August 2013, 40 (8) 1428-1433; DOI: https://doi.org/10.3899/jrheum.130456
Alice B. Gottlieb
From the Department of Dermatology, Tufts Medical Center, Boston, Massachusetts; and Department of Dermatology, University of California Davis, Sacramento, California, USA.
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  • For correspondence: agottlieb@tuftsmedicalcenter.org
April W. Armstrong
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Abstract

Psoriasis is a multisystem disease. The cutaneous and musculoskeletal manifestations (psoriatic arthritis) are well recognized. However, the other manifestations of psoriatic disease including metabolic syndrome, atherosclerotic cardiovascular disease, depression, poor self-esteem, and self-destructive habits including obesity, smoking and excess alcohol consumption are underappreciated. At the 2012 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), members addressed the need to develop uniform, validated, standardized outcome measures for psoriatic disease, measures that are useful to all stakeholders including patients, physicians, regulators, and payers.

Key Indexing Terms:
  • PSORIATIC DISEASE
  • PSORIASIS
  • OMERACT
  • NATIONAL PSORIASIS FOUNDATION
  • COMORBIDITIES

Over the years, several differing models of psoriasis care have emerged: (1) Primary care physicians manage all aspects of psoriatic disease; (2) single specialists manage all aspects of psoriatic disease; (3) multiple specialists work independently on different aspects of psoriatic disease [patient sees a dermatologist for psoriasis and a rheumatologist for psoriatic arthritis (PsA)];(4) multidisciplinary clinics where specialists from different fields work together to care for the patient; and (5) patients drop out of the system, receive no psoriasis care from established medical facilities, or seek over-the-counter and/or alternative care.

While the optimal model would be multiple specialists contributing to care of patients with psoriasis, the reality is that many patients receive no care, or care only from primary care physicians.

We need better psoriasis outcome measures that are useful in the clinic setting and that satisfy the needs of physicians, regulators, payers, and patients, because access is the major obstacle to optimal psoriasis care (Tables 1, 2, 3). In the United States, patients have limited ability to see doctors offering the full repertoire of treatments. Only 25% of US dermatologists use methotrexate, which has been approved for use in psoriasis for decades1. In a National Psoriasis Foundation (NPF) survey, about 50% of patients with severe psoriasis are treated only with topical therapies2.

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Table 1.

Physician-reported disease severity measures in psoriasis.

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Table 2.

Patient-reported disease severity measures in psoriasis.

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Table 3.

Patient-reported quality-of-life measures in psoriasis.

Many dermatologists do not inquire about signs and symptoms of PsA, nor the other manifestations of psoriatic disease, primarily because of economic disincentives3,4. Treating moderate to severe psoriasis patients who require systemic treatment increases office overhead and decreases revenue, especially when compared to treating patients in need of surgical or cosmetic interventions. Payers often stratify physicians based on their cost efficiency (physician tiering), which could appear less cost effective if they offer a full spectrum of therapies for patients with psoriasis. Primary care physicians (PCP) may not refer their patients to specialists who offer a full range of treatments because PCP are financially rewarded for not referring to specialists (e.g., capitation, accountable care organizations). Additionally, patients may be levied high copays or coinsurances to obtain expensive drugs or see physicians offering expensive treatments. Many primary care physicians receive limited training during residency and therefore have inadequate knowledge about the serious aspects of dermatologic diseases. Many patients are not aware of the natural history of their psoriatic diseases or the range of treatment options, and they may not have appropriate expectations regarding the benefits and risks of these treatments. Importantly, patients may not be aware that physicians differ widely in their expertise with regard to psoriasis care. If patients lack access to a comprehensive psoriasis care center or specialists experienced in treating psoriasis, their likelihood of achieving significant improvement in psoriasis severity and their quality of life (QOL) is lower than those with such access. Most patients with moderate to severe psoriasis do not know that they bear an increased risk of dying prematurely due to their psoriasis.

Current psoriasis outcome measures lack aspects of truth, discrimination, and feasibility. They do not measure key aspects of psoriatic disease and are not useful in clinical practice. Further, psoriasis-specific outcomes are not currently captured in routine clinical databases. When payers make decisions on psoriasis treatment algorithms and which physicians to favor for their quality and cost effectiveness, the decision makers do not have available data outside of clinical trials. Psoriasis outcome measures may partially address the needs of clinical researchers and regulators but often do not address the needs of patients or payers, and may not be practical to use in the clinic setting (Tables 1, 2, 3). Many aspects of psoriatic disease are not addressed at all, e.g., QOL, PsA, nail disease, metabolic syndrome, cardiovascular morbidity and mortality, and cost efficacy. Too often, psoriasis is viewed by payers and regulators as largely a cosmetic problem, i.e., not as serious as the rheumatologic disorders.

Table 1 shows the physician-based disease severity outcome measures used currently for regulatory approval and their limitations. The Psoriasis Area and Severity Index (PASI) has been validated in multiple phase 2 and 3 clinical trials5,6,7,8. It has acceptable intraobserver variability but falls short with respect to interobserver variability. It lacks sensitivity, especially in patients with milder disease. It is impractical to use in the clinic setting. It does not measure patient symptoms, e.g., itch, and measures only severity of skin disease. It measures none of the other aspects of psoriatic disease listed above.

The Physician Global Assessment (PGA)5,7,9, although relatively easy to use, with acceptable intra- and interobserver variability, and practical for use in the clinic, fails on multiple levels. It is not standardized (it has both 5-point and 6-point scales), which make the results difficult to compare. PGA measures only lesion morphology and not body surface area (BSA) (Table 1). Investigators are often confused or inconsistent about assessing current lesions or describing them. Partially cleared lesions are difficult to assess. PGA assumes all lesions clear identically at the same rate; in reality this often does not happen. Like PASI, it does not address patient symptoms, QOL, nail disease, or the multisystem expression of psoriatic disease.

While BSA is practical to use in the clinic setting10, it too fails in multiple ways. There is a large degree of interobserver variability. It does not measure the quality or morphology (scaling, erythema, thickness) of lesions. Like PASI and PGA, it does not measure nail changes, QOL, patient symptoms, or other aspects of psoriatic disease. Recently the product of BSA plus PGA has been suggested as a better alternative to the use of BSA and PGA separately7. PASI, BSA, and PGA have been the 3 most common efficacy measures used in phase 2 and 3 clinical trials.

Dermatology Life Quality Index (DLQI) is the most common QOL instrument used in phase 2 and 3 clinical trials of psoriasis (Table 3)11,12. However, DLQI is a generic dermatology QOL measure that is not specific to psoriasis and does not adequately identify the unique QOL of psoriatic disease.

Nail disease has been measured most often in clinical trials by the Nail Psoriasis Severity Index (NAPSI)13. Advantages include being simple to calculate, sensitive to change, and reproducible in clinical trials. However, practicing dermatologists will not be likely to include it in their health records.

Other, less commonly used skin symptom measurement tools include Overall Lesion Assessment14, Overall Lesion Severity Scale15,16, Psoriasis Severity Index17, Psoriasis Assessment Severity Score18,19, Simplified PASI20, Psoriasis Log-based Area and Severity Index19,21, Psoriasis Exact Area and Severity Index19,21, Copenhagen Psoriasis Severity Index22, National Psoriasis Score14,23, Lattice System Physician’s Global Assessment7, Salford Psoriasis Index24, and Dermatology Index of Disease Severity25,26,27 (Table 1). Other patient-assessed disease severity measures are summarized in Table 216,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45. Use of QOL measures is described in Table 311,33,34,35,43,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63.

Dermatologists need to develop uniform, validated, standardized outcome measures for psoriatic disease that are useful to all stakeholders including patients, physicians, regulators, and payers. These measures need to be applicable not only to clinical researchers but also to practicing dermatologists. They have been discussed at an international meeting in January 2013 where attendees determined whether an OMERACT (Outcome Measures in Rheumatoid Arthritis)-like approach will improve the culture of assessment in dermatology. Participants included representatives from OMERACT, GRAPPA, the NPF, patient leaders, payers, regulators, clinical researchers, and epidemiologists/statisticians. Pharmaceutical industry sponsors were invited to attend as observers. A review was conducted of how OMERACT identified which domains to measure for fibromyalgia and PsA and how they designed and validated specific outcome measurement tools for those diseases. Representatives from all attending groups discussed the benefits and shortfalls of current psoriasis outcome measurement instruments and provided their perspectives on what these tools should measure.

The group used techniques similar to those used by OMERACT to identify which disease domains to study64. The group discussed whether to focus solely on the cutaneous manifestations, or if outcome tools should include other aspects of psoriatic disease (e.g., patient-related symptoms, QOL, nail disease, PsA, metabolic syndrome, cardiovascular morbidity and mortality, cost efficacy, and comparative efficacy). Additionally, the group discussed creation and maintenance of an outcomes website for posting key articles and providing a forum for online debate. A Delphi process is being conducted over the following 6 months in order to pick domains to assess with outcome measurement tools. A second psoriasis outcomes meeting is planned to coincide with the GRAPPA annual meeting in Toronto, Canada, in July 2013. Proceedings of all meetings will be submitted for publication.

In conclusion, in order to improve the access of patients to optimal care we need new psoriasis outcome measures that meet the needs of all stakeholders and are feasible to use in clinical practice. It is hoped that improved outcome measures will lead to improved access for patients. The finish line is not at regulatory approval or when an article is published in the New England Journal of Medicine or The Lancet. It is when patients lead their daily lives free from psoriasis, psoriatic arthritis, and their associated comorbidities.

Footnotes

  • Supported in part by a grant from the Advancing Innovation in Dermatology Foundation.

REFERENCES

  1. 1.↵
    1. Wan J,
    2. Abuabara K,
    3. Troxel AB,
    4. Shin DB,
    5. Van Voorhees AS,
    6. Bebo BF Jr.,
    7. et al.
    Dermatologist preferences for first-line therapy of moderate to severe psoriasis in healthy adult patients. J Am Acad Dermatol 2012;66:376–86.
    OpenUrlCrossRefPubMed
  2. 2.↵
    1. Horn EJ,
    2. Fox KM,
    3. Patel V,
    4. Chiou CF,
    5. Dann F,
    6. Lebwohl M
    . Are patients with psoriasis undertreated? Results of National Psoriasis Foundation survey. J Am Acad Dermatol 2007;57:957–62.
    OpenUrlCrossRefPubMed
  3. 3.↵
    1. Crown WH,
    2. Bresnahan BW,
    3. Orsini LS,
    4. Kennedy S,
    5. Leonardi C
    . The burden of illness associated with psoriasis: Cost of treatment with systemic therapy and phototherapy in the US. Curr Med Res Opin 2004;20:1929–36.
    OpenUrlCrossRefPubMed
  4. 4.↵
    1. Kimball AB,
    2. Guerin A,
    3. Tsaneva M,
    4. Yu AP,
    5. Wu EQ,
    6. Gupta SR,
    7. et al.
    Economic burden of comorbidities in patients with psoriasis is substantial. J Eur Acad Dermatol Venereol 2011;25:157–63.
    OpenUrlCrossRefPubMed
  5. 5.↵
    1. Berth-Jones J,
    2. Grotzinger K,
    3. Rainville C,
    4. Pham B,
    5. Huang J,
    6. Daly S,
    7. 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;155:707–13.
    OpenUrlCrossRefPubMed
  6. 6.↵
    1. Fredriksson T,
    2. Pettersson U
    . Severe psoriasis — Oral therapy with a new retinoid. Dermatologica 1978;157:238–44.
    OpenUrlCrossRefPubMed
  7. 7.↵
    1. Langley RG,
    2. Ellis CN
    . Evaluating psoriasis with Psoriasis Area and Severity Index, Psoriasis Global Assessment, and Lattice System Physician’s Global Assessment. J Am Acad Dermatol 2004;51:563–9.
    OpenUrlCrossRefPubMed
  8. 8.↵
    1. Schmitt J,
    2. Wozel G
    . The Psoriasis Area and Severity Index is the adequate criterion to define severity in chronic plaque-type psoriasis. Dermatology 2005;210:194–9.
    OpenUrlCrossRefPubMed
  9. 9.↵
    1. Farhi D,
    2. Falissard B,
    3. Dupuy A
    . Global assessment of psoriasis severity and change from photographs: A valid and consistent method. J Invest Dermatol 2008;128:2198–203.
    OpenUrlCrossRefPubMed
  10. 10.↵
    1. Ramsay B,
    2. Lawrence CM
    . Measurement of involved surface area in patients with psoriasis. Br J Dermatol 1991;124:565–70.
    OpenUrlCrossRefPubMed
  11. 11.↵
    1. Finlay AY,
    2. Khan GK
    . Dermatology Life Quality Index (DLQI) — A simple practical measure for routine clinical use. Clin Exp Dermatol 1994;19:210–6.
    OpenUrlCrossRefPubMed
  12. 12.↵
    1. Rogers A,
    2. DeLong LK,
    3. Chen SC
    . Clinical meaning in skin-specific quality of life instruments: A comparison of the Dermatology Life Quality Index and Skindex banding systems. Dermatol Clin 2012;30:333–42.
    OpenUrlCrossRefPubMed
  13. 13.↵
    1. Rich P,
    2. Scher RK
    . Nail Psoriasis Severity Index: A useful tool for evaluation of nail psoriasis. J Am Acad Dermatol 2003;49:206–12.
    OpenUrlCrossRefPubMed
  14. 14.↵
    1. Feldman SR,
    2. Krueger GG
    . Psoriasis assessment tools in clinical trials. Ann Rheum Dis 2005;64 Suppl 2:ii65–8; discussion ii–9–73.
    OpenUrlAbstract/FREE Full Text
  15. 15.↵
    1. Gordon KB,
    2. Papp KA,
    3. Hamilton TK,
    4. Walicke PA,
    5. Dummer W,
    6. Li N,
    7. et al.
    Efalizumab for patients with moderate to severe plaque psoriasis: A randomized controlled trial. JAMA 2003;290:3073–80.
    OpenUrlCrossRefPubMed
  16. 16.↵
    1. Shikiar R,
    2. Bresnahan BW,
    3. Stone SP,
    4. Thompson C,
    5. Koo J,
    6. Revicki DA
    . Validity and reliability of patient reported outcomes used in psoriasis: Results from two randomized clinical trials. Health Qual Life Outcomes 2003;1:53.
    OpenUrlCrossRefPubMed
  17. 17.↵
    1. Schleyer V,
    2. Radakovic-Fijan S,
    3. Karrer S,
    4. Zwingers T,
    5. Tanew A,
    6. Landthaler M,
    7. et al.
    Disappointing results and low tolerability of photodynamic therapy with topical 5-aminolaevulinic acid in psoriasis. A randomized, double-blind phase I/II study. J Eur Acad Dermatol Venereol 2006;20:823–8.
    OpenUrlPubMed
  18. 18.↵
    1. Harari M,
    2. Shani J,
    3. Hristakieva E,
    4. Stanimirovic A,
    5. Seidl W,
    6. Burdo A
    . Clinical evaluation of a more rapid and sensitive Psoriasis Assessment Severity Score (PASS), and its comparison with the classic method of Psoriasis Area and Severity Index (PASI), before and after climatotherapy at the Dead Sea. Int J Dermatol 2000;39:913–8.
    OpenUrlCrossRefPubMed
  19. 19.↵
    1. Spuls PI,
    2. Lecluse LL,
    3. Poulsen ML,
    4. Bos JD,
    5. Stern RS,
    6. Nijsten T
    . How good are clinical severity and outcome measures for psoriasis?: Quantitative evaluation in a systematic review. J Invest Dermatol 2010;130:933–43.
    OpenUrlCrossRefPubMed
  20. 20.↵
    1. Louden BA,
    2. Pearce DJ,
    3. Lang W,
    4. Feldman SR
    . A Simplified Psoriasis Area Severity Index (SPASI) for rating psoriasis severity in clinic patients. Dermatol Online J 2004;10:7.
    OpenUrlPubMed
  21. 21.↵
    1. Jacobson CC,
    2. Kimball AB
    . Rethinking the Psoriasis Area and Severity Index: The impact of area should be increased. Br J Dermatol 2004;151:381–7.
    OpenUrlCrossRefPubMed
  22. 22.↵
    1. Berth-Jones J,
    2. Thompson J,
    3. Papp K
    . A study examining inter-rater and intrarater reliability of a novel instrument for assessment of psoriasis: The Copenhagen Psoriasis Severity Index. Br J Dermatol 2008;159:407–12.
    OpenUrlCrossRefPubMed
  23. 23.↵
    1. Gottlieb AB,
    2. Chaudhari U,
    3. Baker DG,
    4. Perate M,
    5. Dooley LT
    . The National Psoriasis Foundation Psoriasis Score (NPF-PS) system versus the Psoriasis Area Severity Index (PASI) and Physician’s Global Assessment (PGA): A comparison. J Drugs Dermatol 2003;2:260–6.
    OpenUrlPubMed
  24. 24.↵
    1. Kirby B,
    2. Fortune DG,
    3. Bhushan M,
    4. Chalmers RJ,
    5. Griffiths CE
    . The Salford Psoriasis Index: An holistic measure of psoriasis severity. Br J Dermatol 2000;142:728–32.
    OpenUrlCrossRefPubMed
  25. 25.↵
    1. Ashcroft DM,
    2. Wan Po AL,
    3. Williams HC,
    4. Griffiths CE
    . Clinical measures of disease severity and outcome in psoriasis: A critical appraisal of their quality. Br J Dermatol 1999;141:185–91.
    OpenUrlCrossRefPubMed
  26. 26.↵
    1. Faust HB,
    2. Gonin R,
    3. Chuang TY,
    4. Lewis CW,
    5. Melfi CA,
    6. Farmer ER
    . Reliability testing of the Dermatology Index of Disease Severity (DIDS). An index for staging the severity of cutaneous inflammatory disease. Arch Dermatol 1997;133:1443–8.
    OpenUrlCrossRefPubMed
  27. 27.↵
    1. Williams HC
    . Is a simple generic index of dermatologic disease severity an attainable goal? Arch Dermatol 1997;133:1451–2.
    OpenUrlCrossRefPubMed
  28. 28.↵
    1. Bushnell DM,
    2. Martin ML,
    3. McCarrier K,
    4. Gordon K,
    5. Chiou CF,
    6. Huang X,
    7. et al.
    Validation of the Psoriasis Symptom Inventory (PSI), a patient-reported outcome measure to assess psoriasis symptom severity. J Dermatolog Treat 2012 Dec 8. [Epub ahead of print]
  29. 29.↵
    1. Feldman SR,
    2. Clark AR,
    3. Venkat AP,
    4. Fleischer AB Jr.,
    5. Anderson RT,
    6. Rajagopalan R
    . The Self-Administered Psoriasis Area and Severity Index provides an objective measure of psoriasis severity. Br J Dermatol 2005;152:382–3.
    OpenUrlCrossRefPubMed
  30. 30.↵
    1. Feldman SR,
    2. Fleischer AB Jr.,
    3. Reboussin DM,
    4. Rapp SR,
    5. Exum ML,
    6. Clark AR,
    7. et al.
    The self-administered psoriasis area and severity index is valid and reliable. J Invest Dermatol 1996;106:183–6.
    OpenUrlCrossRefPubMed
  31. 31.↵
    1. Fleischer AB Jr.,
    2. Feldman SR,
    3. Dekle CL
    . The SAPASI is valid and responsive to psoriasis disease severity changes in a multi-center clinical trial. J Dermatol 1999;26:210–5.
    OpenUrlPubMed
  32. 32.↵
    1. Sampogna F,
    2. Sera F,
    3. Mazzotti E,
    4. Pasquini P,
    5. Picardi A,
    6. Abeni D
    . Performance of the self-administered psoriasis area and severity index in evaluating clinical and sociodemographic subgroups of patients with psoriasis. Arch Dermatol 2003;139:353–8; discussion 7.
    OpenUrlCrossRefPubMed
  33. 33.↵
    1. Chren MM,
    2. Lasek RJ,
    3. Flocke SA,
    4. Zyzanski SJ
    . Improved discriminative and evaluative capability of a refined version of Skindex, a quality-of-life instrument for patients with skin diseases. Arch Dermatol 1997;133:1433–40.
    OpenUrlCrossRefPubMed
  34. 34.↵
    1. Hawker GA,
    2. Mian S,
    3. Kendzerska T,
    4. French M
    . Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res 2011;63 Suppl 11:S240–52.
    OpenUrlCrossRef
  35. 35.↵
    1. Cauli A,
    2. Gladman DD,
    3. Mathieu A,
    4. Olivieri I,
    5. Porru G,
    6. Tak PP,
    7. et al.
    Patient global assessment in psoriatic arthritis: a multicenter GRAPPA and OMERACT study. J Rheumatol 2011;38:898–903.
    OpenUrlAbstract/FREE Full Text
  36. 36.↵
    1. Leonardi CL,
    2. Powers JL,
    3. Matheson RT,
    4. Goffe BS,
    5. Zitnik R,
    6. Wang A,
    7. et al.
    Etanercept as monotherapy in patients with psoriasis. N Engl J Med 2003;349:2014–22.
    OpenUrlCrossRefPubMed
  37. 37.↵
    1. Mease PJ
    . Measures of psoriatic arthritis: Tender and Swollen Joint Assessment, Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Modified Nail Psoriasis Severity Index (mNAPSI), Mander/Newcastle Enthesitis Index (MEI), Leeds Enthesitis Index (LEI), Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht Ankylosing Spondylitis Enthesis Score (MASES), Leeds Dactylitis Index (LDI), Patient Global for Psoriatic Arthritis, Dermatology Life Quality Index (DLQI), Psoriatic Arthritis Quality of Life (PsAQOL), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Psoriatic Arthritis Response Criteria (PsARC), Psoriatic Arthritis Joint Activity Index (PsAJAI), Disease Activity in Psoriatic Arthritis (DAPSA), and Composite Psoriatic Disease Activity Index (CPDAI). Arthritis Care Res 2011;63 Suppl 11:S64–85.
    OpenUrlCrossRef
  38. 38.↵
    1. Ortonne JP,
    2. Shear N,
    3. Shumack S,
    4. Henninger E
    . Impact of efalizumab on patient-reported outcomes in high-need psoriasis patients: Results of the international, randomized, placebo-controlled Phase III Clinical Experience Acquired with Raptiva (CLEAR) trial [NCT00256139]. BMC Dermatol 2005;5:13.
    OpenUrlCrossRefPubMed
  39. 39.↵
    1. Revicki D,
    2. Willian MK,
    3. Saurat JH,
    4. Papp KA,
    5. Ortonne JP,
    6. Sexton C,
    7. et al.
    Impact of adalimumab treatment on health-related quality of life and other patient-reported outcomes: Results from a 16-week randomized controlled trial in patients with moderate to severe plaque psoriasis. Br J Dermatol 2008;158:549–57.
    OpenUrlCrossRefPubMed
  40. 40.↵
    1. Revicki DA,
    2. Willian MK,
    3. Menter A,
    4. Saurat JH,
    5. Harnam N,
    6. Kaul M
    . Relationship between clinical response to therapy and health-related quality of life outcomes in patients with moderate to severe plaque psoriasis. Dermatology 2008;216:260–70.
    OpenUrlCrossRefPubMed
  41. 41.↵
    1. Jemec GB,
    2. van de Kerkhof PC,
    3. Enevold A,
    4. Ganslandt C
    . Significant one week efficacy of a calcipotriol plus betamethasone dipropionate scalp formulation. J Eur Acad Dermatol Venereol 2011;25:27–32.
    OpenUrlCrossRefPubMed
  42. 42.↵
    1. Toth DP,
    2. Papp K,
    3. Gratton D
    . Long-term efficacy of up to 15 months’ efalizumab therapy in patients with moderate-to-severe chronic plaque psoriasis. Dermatol Ther 2008;21 Suppl 3:S6–14.
    OpenUrl
  43. 43.↵
    1. Lewis-Jones MS,
    2. Finlay AY
    . The Children’s Dermatology Life Quality Index (CDLQI): Initial validation and practical use. Br J Dermatol 1995;132:942–9.
    OpenUrlCrossRefPubMed
  44. 44.↵
    1. Augustin M,
    2. Wenninger K,
    3. Amon U,
    4. Schroth MJ,
    5. Kuster W,
    6. Chren M,
    7. et al.
    German adaptation of the Skindex-29 questionnaire on quality of life in dermatology: Validation and clinical results. Dermatology 2004;209:14–20.
    OpenUrlCrossRefPubMed
  45. 45.↵
    1. Chren MM,
    2. Lasek RJ,
    3. Quinn LM,
    4. Mostow EN,
    5. Zyzanski SJ
    . Skindex, a quality-of-life measure for patients with skin disease: Reliability, validity, and responsiveness. J Invest Dermatol 1996;107:707–13.
    OpenUrlCrossRefPubMed
  46. 46.↵
    1. Brazier JE,
    2. Harper R,
    3. Jones NM,
    4. O’Cathain A,
    5. Thomas KJ,
    6. Usherwood T,
    7. et al.
    Validating the SF-36 Health Survey questionnaire: New outcome measure for primary care. BMJ 1992;305:160–4.
    OpenUrlAbstract/FREE Full Text
  47. 47.↵
    1. Fong DY,
    2. Lam CL,
    3. Mak KK,
    4. Lo WS,
    5. Lai YK,
    6. Ho SY,
    7. et al.
    The Short Form-12 Health Survey was a valid instrument in Chinese adolescents. J Clin Epidemiol 2010;63:1020–9.
    OpenUrlCrossRefPubMed
  48. 48.↵
    1. Ware J Jr.,
    2. Kosinski M,
    3. Keller SD
    . A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Med Care 1996;34:220–33.
    OpenUrlCrossRefPubMed
  49. 49.↵
    1. Finlay AY,
    2. Khan GK,
    3. Luscombe DK,
    4. Salek MS
    . Validation of Sickness Impact Profile and Psoriasis Disability Index in Psoriasis. Br J Dermatol 1990;123:751–6.
    OpenUrlCrossRefPubMed
  50. 50.↵
    1. Nichol MB,
    2. Margolies JE,
    3. Lippa E,
    4. Rowe M,
    5. Quell J
    . The application of multiple quality-of-life instruments in individuals with mild-to-moderate psoriasis. Pharmacoeconomics 1996;10:644–53.
    OpenUrlPubMed
  51. 51.↵
    1. Morgan M,
    2. McCreedy R,
    3. Simpson J,
    4. Hay RJ
    . Dermatology quality of life scales — A measure of the impact of skin diseases. Br J Dermatol 1997;136:202–6.
    OpenUrlCrossRefPubMed
  52. 52.↵
    1. Augustin M,
    2. Zschocke I,
    3. Seidenglanz K,
    4. Lange S,
    5. Schiffler A,
    6. Amon U
    . Validation and clinical results of the FLQA-d, a quality of life questionnaire for patients with chronic skin disease. Dermatol Psychosom 2000;01:12–7.
    OpenUrlCrossRef
  53. 53.↵
    1. de Bruin AF,
    2. Buys M,
    3. de Witte LP,
    4. Diederiks JP
    . The sickness impact profile: SIP68, a short generic version. First evaluation of the reliability and reproducibility. J Clin Epidemiol 1994;47:863–71.
    OpenUrlCrossRefPubMed
  54. 54.↵
    1. de Bruin AF,
    2. Diederiks JP,
    3. de Witte LP,
    4. Stevens FC,
    5. Philipsen H
    . The development of a short generic version of the Sickness Impact Profile. J Clin Epidemiol 1994;47:407–18.
    OpenUrlCrossRefPubMed
  55. 55.↵
    1. Moorey S,
    2. Greer S,
    3. Watson M,
    4. Gorman C,
    5. Rowden L,
    6. Tunmore R,
    7. et al.
    The factor structure and factor stability of the Hospital Anxiety and Depression Scale in patients with cancer. Br J Psychiatry 1991;158:255–9.
    OpenUrlAbstract/FREE Full Text
  56. 56.↵
    1. Zigmond AS,
    2. Snaith RP
    . The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983;67:361–70.
    OpenUrlCrossRefPubMed
  57. 57.↵
    1. Beck AT,
    2. Steer RA,
    3. Ball R,
    4. Ranieri W
    . Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. J Pers Assess 1996;67:588–97.
    OpenUrlCrossRefPubMed
  58. 58.↵
    1. Beck AT,
    2. Ward CH,
    3. Mendelson M,
    4. Mock J,
    5. Erbaugh J
    . An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561–71.
    OpenUrlCrossRefPubMed
  59. 59.↵
    1. Lipps GE,
    2. Lowe GA,
    3. De La Haye W,
    4. Longman-Mills S,
    5. Clarke TR,
    6. Barton EN,
    7. et al.
    Validation of the Beck Depression Inventory II in HIV-positive patients. West Indian Med J 2010;59:374–9.
    OpenUrlPubMed
  60. 60.↵
    1. Reilly MC,
    2. Zbrozek AS,
    3. Dukes EM
    . The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics 1993;4:353–65.
    OpenUrlCrossRefPubMed
  61. 61.↵
    1. Lerner D,
    2. Amick BC 3rd.,
    3. Rogers WH,
    4. Malspeis S,
    5. Bungay K,
    6. Cynn D
    . The Work Limitations Questionnaire. Med Care 2001;39:72–85.
    OpenUrlCrossRefPubMed
  62. 62.↵
    1. Lerner D,
    2. Reed JI,
    3. Massarotti E,
    4. Wester LM,
    5. Burke TA
    . The Work Limitations Questionnaire’s validity and reliability among patients with osteoarthritis. J Clin Epidemiol 2002;55:197–208.
    OpenUrlCrossRefPubMed
  63. 63.↵
    1. Koo J,
    2. Kozma C,
    3. Reinke K
    . The development of a disease-specific questionnaire to assess quality of life for psoriasis patients: An analysis of the reliability, validity, and responsiveness of the Psoriasis Quality of Life Questionnaire. Dermatol Psychosom 2002;3:171–9.
    OpenUrlCrossRef
  64. 64.↵
    1. Boers M,
    2. Brooks P,
    3. Strand CV,
    4. Tugwell P
    . The OMERACT filter for Outcome Measures in Rheumatology. J Rheumatol 1998;25:198–9.
    OpenUrlPubMed
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1 Aug 2013
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Psoriasis Outcome Measures: A Report from the GRAPPA 2012 Annual Meeting
Alice B. Gottlieb, April W. Armstrong
The Journal of Rheumatology Aug 2013, 40 (8) 1428-1433; DOI: 10.3899/jrheum.130456

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Psoriasis Outcome Measures: A Report from the GRAPPA 2012 Annual Meeting
Alice B. Gottlieb, April W. Armstrong
The Journal of Rheumatology Aug 2013, 40 (8) 1428-1433; DOI: 10.3899/jrheum.130456
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Keywords

PSORIATIC DISEASE
PSORIASIS
OMERACT
NATIONAL PSORIASIS FOUNDATION
COMORBIDITIES

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  • GRAPPA Educational Initiatives: A report from the GRAPPA 2012 Annual Meeting
  • Psoriasis and Psoriatic Arthritis Video Project: An Update from the 2012 GRAPPA Annual Meeting
  • Ultrasound Imaging Module: Report from the GRAPPA 2012 Annual Meeting
Show more Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), Stockholm, Sweden, June 26–27, 2012

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