New, 10-Item Questionnaire Effectively Captures Overall Psoriasis Burden in Adults

Patient filling in medical questionnaire during visit to general doctor
A novel tool assesses the overall individual psoriasis burden in patients.

The feasibility and efficacy of the Individual Burden of Psoriasis (I-BOP) tool for assessing the impact of psoriasis on patients’ quality of life is supported by study data published in Clinical, Cosmetic and Investigational Dermatology. Developed by healthcare professionals, the I-BOP was highly correlated with other validated scales of psoriasis burden and displayed high test-retest reliability.

A group of experts in questionnaire design and dermatology collaborated to design the I-BOP. The initial I-BOP comprised 54 questions, each of which asked patients to rate the effect of psoriasis on activities of daily life. This questionnaire was administered to a random sample of patients at the investigators’ practice facilities in France. An exploratory factor analysis was conducted to identify latent constructs. Questions with too low or too high inter-feature correlation were eliminated. The remaining questions were administered to a validation cohort of patients at the same practice facilities. Patients in the validation cohort also completed the 12-feature Short Form Health Survey, Dermatology Life Quality Index, and Perceived Stress Scale. The I-BOP was externally validated by comparing these questionnaire outcomes to that of the I-BOP. Some patients completed the questionnaire twice, through which test-retest reliability was calculated.

Data from 208 patients were used to develop the I-BOP. Non-discriminating questions—or questions for which >90% of patients provided identical answers—were eliminated from the questionnaire, resulting in an 18-feature I-BOP. Exploratory factor analysis eliminated 8 additional questions, resulting in a 10-feature questionnaire, which was administered to a cohort of 550 patients. Internal coherence was high in this cohort, with a Cronbach’s alpha coefficient of 0.9 for the entire questionnaire. The I-BOP was highly correlated with the physical and mental indices of the Short Form Health Survey, the Dermatology Life Quality Index, and the Perceived Stress Scale. Test-retest reliability was assessed using data from 58 participants. Reproducibility was very good; total intra-class correlation was 0.98. The original French version was translated to English to ensure cross-cultural validity.

As study limitations, investigators noted that these data may not be applicable to pediatric patients; development of a questionnaire for children is ongoing. Further, the development and validation cohorts were derived from a French population, which may limit generalizability to patients in other countries.

The I-BOP represents a means of assessing the overall burden of psoriasis experienced by patients. It is unique from other tools, which tend to measure specific domains of burden rather than overall impact. “[The I-BOP] may help to better appreciate the multidimensional nature of psoriasis…[I]t may help to better understand the individual burden of psoriasis patients and as such may play a key role in the decision-making process,” investigators wrote.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry.

Please see the original reference for a full list of authors’ disclosures.


Ezzedine K, Fougerousse AC, Aubert R, et al. Individual Burden of Psoriasis (I-BOP): building and validation of a new scoring tool for patients with psoriasis. Clin Cosmet Investig Dermatol. 2020;13:325–332