Cardiff Acne Disability Index Offers Effective, Feasible Assessment of Acne-Related QoL

A teenage boy inspecting his acne
A teenage boy inspecting his acne
Published data about the clinical and research value of the Cardiff Acne Disability Index (CADI) is reviewed.

The Cardiff Acne Disability Index (CADI) can act as a practical and effective measure for the assessment of acne-related quality of life impairment in adolescents and young adults. This is according to findings in a literature review study published in the British Journal of Dermatology.

The literature review included acne studies that used the CADI from 1992 to 2020. Investigators extracted interpretability and clinical meaningfulness data for the CADI in these patients. Primary clinical data extracted from the studies were the CADI scores for patients and control participants at both baseline and following intervention.

Frequently reported comparator instruments in 57 studies included the Dermatology Life Quality Index (DLQI), the Global Acne Grading System (GAGS), and the Children’s Dermatology Life Quality Index (CDLQI). In 12 studies, both the CIDA and DLQI scores demonstrated good positive correlations with each other. Significant correlations were also shown between CADI scores and clinicians’ evaluation of acne severity.

According to the researchers of this review study, the minimal clinically important difference of the CADI has not yet been calculated. However, unvalidated score descriptor bands have interpreted relevant data in 25 studies.

The investigators added that the second question in the CADI regarding relationships with the opposite sex does not account for differences in sexual orientations. As such, this question may no longer be appropriate and has recently been rephrased in previous studies to be more inclusive for all patients.

A limitation of this review study was the inclusion of only English language reports. Also, the review lacked a pooled meta-analysis to produce statistical descriptions of the CADI scores’ significance in clinically rating quality of life in people with acne.

The researchers added that “validation of CADI delivery by app or over the phone should be carried out.”

Disclosure: A study author is joint copyright owner of the CADI. Please see the original reference for a full list of disclosures.


Abdelrazik YT, Ali FM, Salek MS, Finlay AY. Clinical experience and psychometric properties of the Cardiff Acne Disability Index (CADI). Br J Dermatol. Published online April 16, 2021. doi:10.1111/bjd.20391