PROMIS Global Health Assessment Can Reliably Evaluate HRQoL in Patients With Atopic Dermatitis

itch pruritus eczema arm
itch pruritus eczema arm
The measurement properties of Patient-Reported Outcomes Measurement Information System Global Health in adult patients with atopic dermatitis is examined.

The Patient-Reported Outcomes Measurement Information Systems (PROMIS) Global Health (PGH) assessment, which includes 5 primary physical and mental health domains, was valid and feasible for the assessment of health-related quality of life (HRQoL) in adult patients with atopic dermatitis (AD), according to study data published in the Journal of the American Academy of Dermatology.

This prospective dermatology-practice study included 994 patients with AD (mean age, 44.7 years) who were recruited from an eczema clinic at a single center. All patients received standard-of-care treatment, such as emollients, prescription topical therapy, systemic therapy, and/or phototherapy. At each encounter, patients answered questions on the PGH assessment, self-reported the severity of their disease, and rated their 7-day itch severity using a 0 to 10 numeric rating scale (NRS) and verbal rating scale (VRS). Additional questionnaires administered at each encounter included the 10-question DLQI and 9-question Patient-Health Questionnaire-9 (PHQ-9).

A dermatologist also performed full-body skin evaluations of each patient. Researchers assessed the clinician-reported outcomes Eczema Area and Severity Index (EASI), Scoring AD (SCORAD), and objective component of the SCORAD.

In terms of concurrent validity, the investigators found very strong correlations with PGH-P4 T scores with its PGH-P2 (rho=0.88) and PGH mental T-scores (rho=0.64). Strong correlations were also found between PGH physical health (PGH-P2) and PGH mental health (PGH-M2) T-scores (rho=0.60) (P <.0001 for all). In addition, Euroqol-5D health utility score (mEQ-5D) held the strongest correlation with the PGH-P4 (rho=0.89; P <.0001) as well as very strong correlations with PGH-M4 T-score (rho=0.81; P <.0001), PGH-P2 (rho=0.72; P <.0001), and PGH-M2 (rho=0.72; P <.0001) T-scores.

The PGH-P4 T-scores also held strong correlations with PO-SCORAD, PROMIS SD, and PHQ-9, as well as moderate correlations with POEM, NRS worst-itch and average-itch, DLQI, EASI, SCORAD, and objective-SCORAD (P <.0001). In terms of validity, the investigators observed significant and stepwise increases of PGH-P4, PGH-M4, PGH-P2, PGH-M2 T-scores, and mEQ-5D scores at each severity level for self-reported global severity (P <.0001).

Limitations of this study were the inclusion of patients from a single center and the use of a single question to determine race and ethnicity.

The researchers concluded that the studied “instruments may provide important information about overall HRQOL that can guide therapeutic decision-making.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Schwartzman G, Lei D, Yousaf M, et al. Validity and reliability of patient-reported outcomes measurement information system global health scale in adults with atopic dermatitis. Published online January 20, 2021. J Am Acad Dermatol. doi:10.1016/j.jaad.2021.01.033