The use of patient-reported outcome measures (PROMs) to complement clinician-reported outcomes (CROs) may yield important information for assessing disease severity and guiding treatment of psoriasis, according to a research letter published online Sept. 8 in JAMA Dermatology.
John S. Barbieri, M.D., and Joel M. Gelfand, M.D., both from the University of Pennsylvania Perelman School of Medicine in Philadelphia, used data from the Dermatology Clinical Effectiveness Research Network (February 2010 through June 2011) to evaluate the potential complementary value of PROMs (using the Dermatology Life Quality Index [DLQI]) and CROs (using the Psoriasis Area Severity Index [PASI] or body surface area [BSA]) among 1,733 patients being treated for psoriasis in routine clinical practice.
The researchers found that 41.8 percent of patients had a one-level difference in disease severity for DLQI versus PASI and 35.5 percent had a one-level difference versus BSA, while a two-level difference in disease severity was seen in 9.1 percent of patients with the DLQI versus PASI and 11.5 percent versus BSA. Among patients with psoriasis not meeting the criteria for systemic therapy initiation based on either PASI scores or BSA, nearly three-quarters also did not meet criteria using DLQI (72.4 percent). However, 10.4 percent of patients not meeting criteria using PASI or BSA did meet criteria using DLQI.
“These findings highlight that evaluating patients with CROs or PROMs alone could lead to an incomplete understanding of disease severity, which may lead to undertreatment or overtreatment,” the authors write.
Gelfand disclosed financial ties to the pharmaceutical industry.