Validity and reliability of itch assessment scales for chronic pruritus in adults: A prospective multicenter study

Yong Hyun Jang; Seok Min Kim; Dong Hyuk Eun; Kyung Duck Park; Gyeong Hun Park; Byung Soo Kim; Kapsok Li; Chang Ook Park; Hye One Kim; Hei Sung Kim; Min Soo Jang; Eun Jin Doh; Dong Hun Lee; Yang Won Lee; Do Won Kim; Seong Jin Kim

doi:10.1016/j.jaad.2019.06.043

Validity and reliability of itch assessment scales for chronic pruritus in adults: A prospective multicenter study

Yong Hyun Jang, Seok Min Kim, Dong Hyuk Eun, Kyung Duck Park, Gyeong Hun Park, Byung Soo Kim, Kapsok Li, Chang Ook Park, Hye One Kim, Hei Sung Kim, Min Soo Jang, Eun Jin Doh, Dong Hun Lee, Yang Won Lee, Do Won Kim, Seong Jin Kim

Department of Medicine

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

Background: Several tools can provide a reliable and accurate evaluation of pruritus, including the visual analog scale (VAS), numeric rating scale (NRS), verbal rating scale (VRS), and multidimensional questionnaires such as the Itch Severity Scale (ISS). However, no single method is considered a gold standard. Objective: We evaluated the validity and reliability of VAS, NRS, VRS, and ISS and their correlation with a pruritus-specific quality of life instrument, ItchyQoL. Methods: A total of 419 patients (215 men and 204 women) with chronic pruritus (mean age, 46.58 years) recorded their pruritus intensity on VAS, NRS, VRS, and ISS. Retest reliability was analyzed in a second assessment 3 hours after the initial assessment. All participants answered ItchyQoL. Results: A strong correlation between VAS, NRS, and VRS was found. ISS showed a low intercorrelation validity with these tools. However, ISS was more strongly correlated with ItchyQoL. The retest reliability scores were similar for VAS, NRS, and VRS but lower than the scores obtained for ISS. Limitations: Limitations include patient heterogeneity and recall bias. Conclusion: The assessment of pruritus is challenging because of the subjective symptoms and the multifactorial nature. Therefore, more studies are needed to determine the best strategy to assess itch intensity.

Original language	English
Pages (from-to)	80-86
Number of pages	7
Journal	Journal of the American Academy of Dermatology
Volume	82
Issue number	1
DOIs	https://doi.org/10.1016/j.jaad.2019.06.043
State	Published - Jan 2020

Keywords

atopic dermatitis
eczema
itch
pruritus
quality of life
urticaria

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Jang, Y. H., Kim, S. M., Eun, D. H., Park, K. D., Park, G. H., Kim, B. S., Li, K., Park, C. O., Kim, H. O., Kim, H. S., Jang, M. S., Doh, E. J., Lee, D. H., Lee, Y. W., Kim, D. W., & Kim, S. J. (2020). Validity and reliability of itch assessment scales for chronic pruritus in adults: A prospective multicenter study. Journal of the American Academy of Dermatology, 82(1), 80-86. https://doi.org/10.1016/j.jaad.2019.06.043

@article{fd44ad03baa54e76bd1a551d6a194a67,

title = "Validity and reliability of itch assessment scales for chronic pruritus in adults: A prospective multicenter study",

abstract = "Background: Several tools can provide a reliable and accurate evaluation of pruritus, including the visual analog scale (VAS), numeric rating scale (NRS), verbal rating scale (VRS), and multidimensional questionnaires such as the Itch Severity Scale (ISS). However, no single method is considered a gold standard. Objective: We evaluated the validity and reliability of VAS, NRS, VRS, and ISS and their correlation with a pruritus-specific quality of life instrument, ItchyQoL. Methods: A total of 419 patients (215 men and 204 women) with chronic pruritus (mean age, 46.58 years) recorded their pruritus intensity on VAS, NRS, VRS, and ISS. Retest reliability was analyzed in a second assessment 3 hours after the initial assessment. All participants answered ItchyQoL. Results: A strong correlation between VAS, NRS, and VRS was found. ISS showed a low intercorrelation validity with these tools. However, ISS was more strongly correlated with ItchyQoL. The retest reliability scores were similar for VAS, NRS, and VRS but lower than the scores obtained for ISS. Limitations: Limitations include patient heterogeneity and recall bias. Conclusion: The assessment of pruritus is challenging because of the subjective symptoms and the multifactorial nature. Therefore, more studies are needed to determine the best strategy to assess itch intensity.",

keywords = "atopic dermatitis, eczema, itch, pruritus, quality of life, urticaria",

author = "Jang, {Yong Hyun} and Kim, {Seok Min} and Eun, {Dong Hyuk} and Park, {Kyung Duck} and Park, {Gyeong Hun} and Kim, {Byung Soo} and Kapsok Li and Park, {Chang Ook} and Kim, {Hye One} and Kim, {Hei Sung} and Jang, {Min Soo} and Doh, {Eun Jin} and Lee, {Dong Hun} and Lee, {Yang Won} and Kim, {Do Won} and Kim, {Seong Jin}",

note = "Publisher Copyright: {\textcopyright} 2019 American Academy of Dermatology, Inc.",

year = "2020",

month = jan,

doi = "10.1016/j.jaad.2019.06.043",

language = "English",

volume = "82",

pages = "80--86",

journal = "Journal of the American Academy of Dermatology",

issn = "0190-9622",

publisher = "Elsevier Inc.",

number = "1",

}

Jang, YH, Kim, SM, Eun, DH, Park, KD, Park, GH, Kim, BS, Li, K, Park, CO, Kim, HO, Kim, HS, Jang, MS, Doh, EJ, Lee, DH, Lee, YW, Kim, DW & Kim, SJ 2020, 'Validity and reliability of itch assessment scales for chronic pruritus in adults: A prospective multicenter study', Journal of the American Academy of Dermatology, vol. 82, no. 1, pp. 80-86. https://doi.org/10.1016/j.jaad.2019.06.043

TY - JOUR

T1 - Validity and reliability of itch assessment scales for chronic pruritus in adults

T2 - A prospective multicenter study

AU - Jang, Yong Hyun

AU - Kim, Seok Min

AU - Eun, Dong Hyuk

AU - Park, Kyung Duck

AU - Park, Gyeong Hun

AU - Kim, Byung Soo

AU - Li, Kapsok

AU - Park, Chang Ook

AU - Kim, Hye One

AU - Kim, Hei Sung

AU - Jang, Min Soo

AU - Doh, Eun Jin

AU - Lee, Dong Hun

AU - Lee, Yang Won

AU - Kim, Do Won

AU - Kim, Seong Jin

PY - 2020/1

Y1 - 2020/1

N2 - Background: Several tools can provide a reliable and accurate evaluation of pruritus, including the visual analog scale (VAS), numeric rating scale (NRS), verbal rating scale (VRS), and multidimensional questionnaires such as the Itch Severity Scale (ISS). However, no single method is considered a gold standard. Objective: We evaluated the validity and reliability of VAS, NRS, VRS, and ISS and their correlation with a pruritus-specific quality of life instrument, ItchyQoL. Methods: A total of 419 patients (215 men and 204 women) with chronic pruritus (mean age, 46.58 years) recorded their pruritus intensity on VAS, NRS, VRS, and ISS. Retest reliability was analyzed in a second assessment 3 hours after the initial assessment. All participants answered ItchyQoL. Results: A strong correlation between VAS, NRS, and VRS was found. ISS showed a low intercorrelation validity with these tools. However, ISS was more strongly correlated with ItchyQoL. The retest reliability scores were similar for VAS, NRS, and VRS but lower than the scores obtained for ISS. Limitations: Limitations include patient heterogeneity and recall bias. Conclusion: The assessment of pruritus is challenging because of the subjective symptoms and the multifactorial nature. Therefore, more studies are needed to determine the best strategy to assess itch intensity.

AB - Background: Several tools can provide a reliable and accurate evaluation of pruritus, including the visual analog scale (VAS), numeric rating scale (NRS), verbal rating scale (VRS), and multidimensional questionnaires such as the Itch Severity Scale (ISS). However, no single method is considered a gold standard. Objective: We evaluated the validity and reliability of VAS, NRS, VRS, and ISS and their correlation with a pruritus-specific quality of life instrument, ItchyQoL. Methods: A total of 419 patients (215 men and 204 women) with chronic pruritus (mean age, 46.58 years) recorded their pruritus intensity on VAS, NRS, VRS, and ISS. Retest reliability was analyzed in a second assessment 3 hours after the initial assessment. All participants answered ItchyQoL. Results: A strong correlation between VAS, NRS, and VRS was found. ISS showed a low intercorrelation validity with these tools. However, ISS was more strongly correlated with ItchyQoL. The retest reliability scores were similar for VAS, NRS, and VRS but lower than the scores obtained for ISS. Limitations: Limitations include patient heterogeneity and recall bias. Conclusion: The assessment of pruritus is challenging because of the subjective symptoms and the multifactorial nature. Therefore, more studies are needed to determine the best strategy to assess itch intensity.

KW - atopic dermatitis

KW - eczema

KW - itch

KW - pruritus

KW - quality of life

KW - urticaria

UR - http://www.scopus.com/inward/record.url?scp=85074152499&partnerID=8YFLogxK

U2 - 10.1016/j.jaad.2019.06.043

DO - 10.1016/j.jaad.2019.06.043

M3 - Article

C2 - 31255747

AN - SCOPUS:85074152499

SN - 0190-9622

VL - 82

SP - 80

EP - 86

JO - Journal of the American Academy of Dermatology

JF - Journal of the American Academy of Dermatology

IS - 1

ER -

Validity and reliability of itch assessment scales for chronic pruritus in adults: A prospective multicenter study

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