Clinician-reported outcome measures for the assessment of vitiligo: A scoping review

Clinician-reported outcome measures (ClinROMs) are essential for assessment of vitiligo in clinical trials and daily practice. Several instruments have been developed and tested to measure, for example, vitiligo extent, re pigmentation and activity. The goal of this review was to identify all introductory publications of ClinROMs for vitiligo that include at least some aspects of validation and to describe the instruments' characteristics, intention for use and practical strengths and limitations. A search strategy was conducted in PubMed, Embase and Cochrane Library (CENTRAL) from inception to July 2022. Based on the literature search (n = 2860), 10 articles were identified, describing 14 different ClinROMs. Six ClinRoms measured disease extent and/or re pigmentation, seven evaluated disease activity and one was a composite score. The Vitiligo Area Scoring Index (VASI), and Vitiligo Extent Score (VES and VESplus) measure overall disease extent and/or re pigmentation. The VASI relies on hand units (1% body surface area), whereas the VES and VESplus use a picture-based scoring technique. The Vitiligo Extent Score for a Target Area (VESTA) measures re pigmentation percentage for target lesions. One global assessment score for ex-tent has been validated. Vitiligo disease activity scores included a static measure of clinical activity signs (Vitiligo Signs of Activity Score [VSAS]) and two measures assessing dynamic evolution (Vitiligo Disease Activity Score [VDAS] and Vitiligo Disease Improvement Score [VDIS]). The Vitiligo European Task Force assessment tool (VETFa) is a composite score. Depending on the practical strengths and limitations as well as the research question and setting (clinical trials vs. daily practice), the choice of an appropriate ClinROM may differ. Fourteen ClinROMs in vitiligo were identified to measure vitiligo extent, re pigmentation, and activity. Further re-search evaluating the validity, reliability, and responsiveness of each instrument and worldwide consensus on which instrument to use for a specific outcome (domain) is greatly needed.

Aim

The aim of this scoping review is to give an overview of the existing Clinician-reported outcome measures (Clin-ROMs) for measuring vitiligo (e.g., extent, re pigmentation and activity), that have been evaluated for at least one aspect of validation and describe their characteristics, intention for use and summarize their practical strengths and limitations based on the selected articles.

Contributors

Nanja van Geel, Jolien Duponselle, Liesbeth Delbaere, Sandrine Herbelet, Viktoria Eleftheriadou, Khaled Ezzedine, Maxine Forman, Amit Garg, Iltefat H. Hamzavi, Julien Seneschal, Phyllis Spuls, Caroline B. Terwee, Albert Wolkerstorfer, Reinhart Speeckaert, Amit G. Pandya

Publication

Journal: Journal of the European Academy of Dermatology and Venereology
Volume: 37
Issue: 11
Pages: 2231 - 2242
Year: 2023
DOI: 10.1111/jdv.19448

Further Study Information

Current Stage: Completed
Date:
Funding source(s): The research activities of N. van Geel and R. Speeckaert are supported by the Scientific Research Foundation-Flanders (FWO Senior Clinical Investigator: 1831512N and 18B2721N respectively). This VITAL project was supported by a grant from Incyte Biosciences International Sàrl, Abbvie and CHORD COUSIN Collaboration (C3).


Health Area

Disease Category: Skin

Disease Name: Vitiligo

Target Population

Age Range: Unknown

Sex: Either

Nature of Intervention:

Stakeholders Involved

Study Type

- Systematic review of outcome measures/measurement instruments

Method(s)

- Systematic review

For the broader literature search three electronic databases, PubMed, Embase and Cochrane Library (CENTRAL), were screened.