Validation of four single-item patient-reported assessments of sleep in adult atopic dermatitis patients

Donald Lei, Muhammad Yousaf, Sherief R Janmohamed, Paras P Vakharia, Rishi Chopra, Rajeev Chavda, Sylvie Gabriel, Ryan Sacotte, Kevin R Patel, Vivek Singam, Supriya Immaneni, Robert Kantor, Derek Y Hsu, Jonathan I Silverberg

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


BACKGROUND: The optimal approaches for monitoring sleep disturbances in adults with atopic dermatitis (AD) is not established. Multiple patient-reported outcome measures for AD and itch have sleep-related items. These items have not been validated previously.

OBJECTIVE: Assess the measurement properties of sleep-related items from the Patient-Oriented Eczema Measure (POEM), SCORing AD (SCORAD), 5-dimensions of itch (5D), and ItchyQOL in adults with AD.

METHODS: We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n = 115).

RESULTS: There was modest overlap and weak-moderate concordance of responses to the different assessments. Regarding concurrent validity, POEM-sleep, SCORAD-sleep, 5D-sleep, and ItchyQOL-sleep showed moderate correlations with each other. Regarding convergent validity, all items showed moderate correlation with total POEM, but weak correlations with Eczema Area and Severity Index (EASI), objective and total SCORAD, moderate to strong correlations with mean ItchyQOL and Dermatology Life Quality Index (DLQI), but poor or no significant correlation with Numeric Rating Scale (NRS) for worst or average itch. Regarding discriminant validity, all items showed significant and stepwise increases with increasing self-reported and physician-reported AD severity (Kruskal-Wallis, P < .01 for all). Floor effects were observed for POEM-sleep (n = 53, 46.1%), SCORAD-sleep (n = 28, 24.4%), 5D-sleep (n = 41, 35.7%), and ItchyQOL-sleep (n = 33, 28.7%); no ceiling effects were observed. Change in sleep-related item scores showed moderate strong correlations with change in POEM, 5Ditch, mean ItchyQOL, DLQI, objective and total SCORAD, and EASI, but inconsistent correlations with change of itch severity.

Original languageEnglish
Pages (from-to)261-266
Number of pages6
JournalAnnals of Allergy, Asthma & Immunology
Issue number3
Early online date9 Dec 2019
Publication statusPublished - Mar 2020

Bibliographical note

Copyright © 2019 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.


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