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Exploring the severity strata of disease activity and repigmentation in vitiligo based on validated Physician Global Assessment (PGA) scores

Title: Exploring the severity strata of disease activity and repigmentation in vitiligo based on validated Physician Global Assessment (PGA) scores
Authors: van Geel, Nanja; Delbaere, Liesbeth; Mertens, Laura; Vandaele, Virginie; Depaepe, Lien; Van Causenbroeck, Jérôme; De Schepper, Sofie; Van Coile, Laura; Van Reempts, Astrid; De Vos, Ann-Sophie; Papeleu, Jorien; Hoorens, Isabelle; Wolkerstorfer, Albert; Speeckaert, Reinhart
Source: JOURNAL OF CLINICAL MEDICINE ; ISSN: 2077-0383
Publication Year: 2024
Collection: Ghent University Academic Bibliography
Subject Terms: Medicine and Health Sciences; vitiligo; activity; physician-reported outcome; stratification; measurement instrument; outcome; COSMIN
Description: Background/Objectives: There is currently no guidance on how to interpret the global degrees of activity (worsening) and repigmentation (improvement) in vitiligo. Stratification into global degrees can be completed for static evaluations (e.g., visible disease activity signs) and dynamic assessments (e.g., evolution over time). For the latter, the Vitiligo Disease Activity Score (VDAS(15&60)) and Vitiligo Disease Improvement Score (VDIS15&60) were recently validated. Methods: In the current study, a Physician Global Assessment (PGA) for disease activity (worsening) and repigmentation (improvement) was evaluated for validity (construct) and reliability (inter- and intrarater) based on a photo set of 66 patients. Subsequently, the PGA activity (worsening) and repigmentation (improvement) were used to stratify the Vitiligo Extent Score plus (VESplus), VDAS(15&60) or VDIS15&60 into three global categories (slightly, moderately and much worse/improved), based on ROC analysis. Results: For the VESplus, cut-off values for the categories 'slightly, moderately and much worse' were >0.3%, >27.71% and >128.75% BSA (relative changes in the affected total BSA), respectively. For the categories 'slightly, moderately and much improved', they were >0%, >4.87% and >36.88% BSA (relative changes in the affected total BSA), respectively. The optimal cut-off values of the number of active (VDAS(15)) body areas were >0 areas for slightly worse, >2 areas for moderately worse and >7 for much worse. For VDIS15, the cut-off values for slightly improved and moderately improved were >0 and >1. For VDAS(60) and VDIS60, the cut-off points were >0.5, >3, >9.5 and >0.5 and >1.5, respectively. The results should be interpreted with caution in patients with extensive vitiligo due to the rather limited disease extent of the included patient population (VESplus (median: 3.2%)). Conclusions: This research will aid in the development of more detailed international definitions.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
Relation: https://biblio.ugent.be/publication/01J719SNJ10P400HSQEBQPVMH7; https://doi.org/10.3390/jcm13092680; https://biblio.ugent.be/publication/01J719SNJ10P400HSQEBQPVMH7/file/01J7K46TSBP9A98JBGGKNZ8WB2
DOI: 10.3390/jcm13092680
Availability: https://biblio.ugent.be/publication/01J719SNJ10P400HSQEBQPVMH7; https://hdl.handle.net/1854/LU-01J719SNJ10P400HSQEBQPVMH7; https://doi.org/10.3390/jcm13092680; https://biblio.ugent.be/publication/01J719SNJ10P400HSQEBQPVMH7/file/01J7K46TSBP9A98JBGGKNZ8WB2
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.37F0F7C6
Database: BASE