Translating patient-oriented eczema measure (POEM) scores into clinical practice by suggesting severity strata derived using anchor-based methods

摘要

Background The Patient-Oriented Eczema Measure (POEM) is a validated, patient-derived assessment measure for monitoring atopic eczema severity, although further information on how different POEM scores translate into disease severity categories is needed for clinical trials, epidemiological research and audit. Objectives We sought to determine the relationship between Patient-Oriented Eczema Measure (POEM) scores (range 0-28) and two Global Questions (GQ1 and 2) concerning patients'/parents' views of the overall severity of their/their child's atopic eczema, in order to stratify POEM scores into five severity bands. Methods POEM scores and GQs were completed by 300 patients from general practice and 700 patients from dermatology outpatient clinics, including 300 adults aged ≥ 16 years and 700 children. Results The mean POEM score was 13·6 (range 0-28), and standard deviation (SD) was 7·2. Mean GQ1/GQ2 scores were 2·1/2·1, respectively (range 0-4 and SD 1·1 for both). The mean, mode and median of the GQ scores for each POEM score were used to devise possible POEM bandings. The proposed banding for POEM scores are: 0-2 (clear/almost clear); 3-7 (mild); 8-16 (moderate); 17-24 (severe); 25-28 (very severe), kappa coefficient 0·46. Conclusions Severity banding of the POEM will allow more clinically meaningful use in everyday clinical practice and as a core outcome measure in future atopic eczema research. What's already known about this topic? The POEM is a validated, reliable and simple tool for measuring atopic eczema severity in adults and children. POEM scores can range from 0 to 28, and have shown longitudinal sensitivity to change in the outpatient clinic and in clinical trials. What does this study add? Using global patient-assessed anchor questions, POEM scores were categorized into five severity bands to improve interpretation in clinical practice and research. POEM scores of 0-2 = clear/almost clear, 3-7 = mild, 8-16 = moderate, 17-24 = severe, and 25-28 = very severe atopic eczema. See also the Commentary by Ingram