Not relevant responses on the DLQI from psoriasis patients

[Fred]

This study suggests a reconsideration of the use of the DLQI for medical and financial decision-making in psoriasis patients is needed.

Quote:

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Background:
Dermatology Life Quality Index (DLQI) is the most common health-related quality of life measure in dermatology that is widely used in treatment guidelines for psoriasis. Eight out of the 10 questions of the DLQI offer a ‘not relevant’ response (NRR) option that is scored as the item had no impact on patients’ life at all.

Objective:
To explore the occurrence of NRRs on the DLQI in psoriasis patients, and to examine the effect of several socio-demographic and clinical factors on giving NRRs.

Methods:
Data were obtained from two cross-sectional surveys among psoriasis patients at two academic dermatology clinics in Hungary. Health-related quality of life was measured by employing DLQI and EQ-5D-3L, while disease severity was graded by Psoriasis Area and Severity Index (PASI). Multivariate logistic regression was applied to determine the predictors of providing NRRs.

Results:
Mean age of the 428 patients was 49 years, and 65% were males. Mean PASI, DLQI and EQ-5D-3L index scores were 8.4±9.5, 6.8±7.4 and 0.74±0.28, respectively. Overall, 38.8% of the patients had at least one NRR: 19.6% (one), 11.5% (two), 5.1% (three) and 2.6% (more than three). Most NRRs occurred in sport, sexual difficulties and working/studying items of the DLQI (28.4%, 16.4% and 14.0%, respectively). Female gender (OR 1.65; 95% CI 1.04-2.61), older age (OR 1.05; 95% CI 1.03-1.07) and higher PASI score (OR 1.03; 95% CI 1.01-1.06) were associated with providing more NRRs, whereas highly educated patients (OR 0.34; 95% CI 0.16-0.72) and those with a full-time job (OR 0.47; 95% CI 0.29-0.77) less frequently tended to tick NRRs.

Conclusion:
The high rate of psoriasis patients with NRRs, especially among women, less educated and elderly patients, indicates a content validity problem of the measure. A reconsideration of the use of the DLQI for medical and financial decision-making in psoriasis patients is suggested.

Source: onlinelibrary.wiley.com

*Early view funding unknown.

Dermatology Life Quality Index (DLQI)

[jiml]

That's very interesting I think it would have been a good thing at my dermatology unit over the years.....I have never been asked to complete one

If they are reconsidering it's use ...what is planned in its place or will they just mark the scores differently and ask different questions

[Fred]

That's very interesting I think it would have been a good thing at my dermatology unit over the years.....I have never been asked to complete one

If they are reconsidering it's use ...what is planned in its place or will they just mark the scores differently and ask different questions

I don't know what can replace it but it was mentioned a while back that it could be time for something new: Newer measure of psoriasis severity is needed.

My dermatologist no longer bothers doing it with me as I always say none of the questions are relevant.

[jiml]

That's very interesting I think it would have been a good thing at my dermatology unit over the years.....I have never been asked to complete one

If they are reconsidering it's use ...what is planned in its place or will they just mark the scores differently and ask different questions

I don't know what can replace it but it was mentioned a while back that it could be time for something new: Newer measure of psoriasis severity is needed.

My dermatologist no longer bothers doing it with me as I always say none of the questions are relevant.

If I had to fill one in they would say there's no further need for treatment as all my answers based on the last week would score a zero
I'm sure most would opt for the obvious choices which would give a higher score if they wanted to get decent medication

The psoriasis scoring system here is far more accurate and something along those lines would be more useful

[Fred]

I'm sure most would opt for the obvious choices which would give a higher score if they wanted to get decent medication

Yes always good to make it sound worse when looking for a new treatment.

[artemie]

the AMC hospital in Amsterdam, Netherlands has it's own and it's more than one page. Made me feel like shit filling it in

[Fred]

the AMC hospital in Amsterdam, Netherlands has it's own and it's more than one page. Made me feel like shit filling it in

[Turnedlight]

Yes! Great, I thought it was completely irrelevant when I did it (if the quality if life questionnaire I did was the same one..)
I lost marks because I didn't work at the time, and didn't score that highly overall and that made me feel like I should accept it was completely ok to be covered in plaques.
Silly thing was, my flare up and going on mtx was a contributory factor to me stopping working, though not the only reasons. But I was a little annoyed that quality of life might only be important to 'real' people in jobs.

[JohnB]

I've filled a DLQI in twice at my Dermy and always thought the timescale of a week was poor. A month or six would be a better measure. I can see what they are trying to do but it was obviously created by somebody who has never had Psoriasis.