TY - JOUR

T1 - The Agreement between Consumer-Driven Self-Assessment of Psoriasis Severity and Physician-Assessed Severity Based on Patient-Taken Photographs Is Weak

T2 - A Cross-Sectional Study

AU - Ali, Zarqa

AU - Al-Mousawi, Ali

AU - Björnsson, Benóný Þór

AU - Egeberg, Alexander

AU - Riemer, Christian

AU - Thomsen, Simon Francis

N1 - Publisher Copyright: © 2024 The Author(s). Published by S. Karger AG, Basel.

PY - 2024

Y1 - 2024

N2 - Introduction: Digital advancements have given access to huge amounts of real-world data (RWD) widely used for dermatological research. Objectives: The objective of this study was to investigate the agreement between consumer-driven selfassessed psoriasis severity and physician-assessed severity based on photographs. Methods: Customer IDs in the NØIE database (Danish skincare company) from 2009 to 2022 with a smartphone photograph of psoriasis vulgaris on the body and a corresponding completed questionnaire were included. Smartphone photographs were evaluated by a physicianassessing erythema, induration, and scaling on a scale from 0 to 4 based on Psoriasis Area Severity Index (PASI). Selfassessment was done on a scale from 0 to 10 and converted to 0-4 scale(0converted to0; 1-3 to1; 4-6 to2;7-8 to3; and 9-10 to 4). Intraclass correlation coefficients with 95% confidence intervals (CIs) were calculated. Results: In total, 187 patients (63% women) with mean age of 38 years were included. Self-assessment scores were higher than physicians' assessment scores for all groups, and scaling was closest to the physicians' assessment, while erythema and induration had a greater distance between the physicians' and patients' assessment. The correlation between self-assessed and physicianassessed psoriasis severity for all patients was 0.23 (95% CI: 0.0-0.92); 0.34 (95% CI: 0.0-0.95) for chronic patients; and 0.09 (-0.01 to 0.82) for non-chronic patients. The agreement was better for men (0.53 [-0.02 to 0.98]) than for women (0.12 [-0.01 to 0.84]). Conclusion: There was weak agreement between self-assessed psoriasis severity and photographically assessed severity by the physician. Consumer-driven RWD should be interpreted with caution.

AB - Introduction: Digital advancements have given access to huge amounts of real-world data (RWD) widely used for dermatological research. Objectives: The objective of this study was to investigate the agreement between consumer-driven selfassessed psoriasis severity and physician-assessed severity based on photographs. Methods: Customer IDs in the NØIE database (Danish skincare company) from 2009 to 2022 with a smartphone photograph of psoriasis vulgaris on the body and a corresponding completed questionnaire were included. Smartphone photographs were evaluated by a physicianassessing erythema, induration, and scaling on a scale from 0 to 4 based on Psoriasis Area Severity Index (PASI). Selfassessment was done on a scale from 0 to 10 and converted to 0-4 scale(0converted to0; 1-3 to1; 4-6 to2;7-8 to3; and 9-10 to 4). Intraclass correlation coefficients with 95% confidence intervals (CIs) were calculated. Results: In total, 187 patients (63% women) with mean age of 38 years were included. Self-assessment scores were higher than physicians' assessment scores for all groups, and scaling was closest to the physicians' assessment, while erythema and induration had a greater distance between the physicians' and patients' assessment. The correlation between self-assessed and physicianassessed psoriasis severity for all patients was 0.23 (95% CI: 0.0-0.92); 0.34 (95% CI: 0.0-0.95) for chronic patients; and 0.09 (-0.01 to 0.82) for non-chronic patients. The agreement was better for men (0.53 [-0.02 to 0.98]) than for women (0.12 [-0.01 to 0.84]). Conclusion: There was weak agreement between self-assessed psoriasis severity and photographically assessed severity by the physician. Consumer-driven RWD should be interpreted with caution.

KW - Photograph

KW - Psoriasis

KW - Self-assessment

KW - Tele-dermatology

U2 - 10.1159/000536175

DO - 10.1159/000536175

M3 - Journal article

C2 - 38198756

AN - SCOPUS:85195029217

VL - 240

SP - 362

EP - 368

JO - Dermatology

JF - Dermatology

SN - 1018-8665

ER -