Measurement properties of the Rajka-Langeland severity score in children and adults with atopic dermatitis.

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Multiple atopic dermatitis (AD) severity scales exist, with no gold-standard for use in clinical practice.Determine the measurement properties of the Rajka-Langeland score and compare with other clinician-reported outcomes in adults and children with AD.We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n=424).Rajka-Langeland had good concurrent validity with eczema area and severity index (EASI)(Spearman rho=0.63), Scoring AD (SCORAD) (rho=0.61), objective-SCORAD (rho=0.52) and body surface area (BSA) (rho=0.51); good convergent validity with Numeric Rating Scale (NRS) average-itch (rho=0.60) and worst-itch (rho=0.59), Patient-Oriented Eczema Measure (POEM) (rho=0.57), Dermatology Life Quality Index (DLQI) (rho=0.53), PROMIS Itch Questionnaire (rho=0.35-0.55) in adults and/or children; fair discriminant validity for patient- and physician-reported global AD severity; good responsiveness to change of severity of AD and itch; good reliability; internal consistency; with no floor or ceiling effects. Interpretability bands (3=clear-almost clear/4-5=mild/6-7=moderate/8-9=severe) and minimal clinically important difference (1-point) were established.Rajka-Langeland score showed good construct validity, reliability, internal consistency and responsiveness in adults and children with AD.


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