FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W1999647535> ?p ?o ?g. }

• W1999647535 endingPage "13" @default.
• W1999647535 startingPage "11" @default.
• W1999647535 abstract "Since its introduction in 1994, the Dermatology Life Questionnaire Index (DLQI) has played an important role in assessing dermatology-specific health-related quality of life (HRQoL) and has affected several medical decision-making processes. However, the psychometric requirements for instruments have evolved over the years, and the DQLI is failing these new standards. Therefore, it is time to move forward and use valuable alternatives because the DLQI’s scientific limitations outweigh the practicalities of its use. Since its introduction in 1994, the Dermatology Life Questionnaire Index (DLQI) has played an important role in assessing dermatology-specific health-related quality of life (HRQoL) and has affected several medical decision-making processes. However, the psychometric requirements for instruments have evolved over the years, and the DQLI is failing these new standards. Therefore, it is time to move forward and use valuable alternatives because the DLQI’s scientific limitations outweigh the practicalities of its use. The Dermatology Life Questionnaire Index (DLQI) (Finlay and Khan, 1994Finlay A.Y. Khan G.K. Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use.Clin Exp Dermatol. 1994; 19: 210-216Crossref PubMed Scopus (3167) Google Scholar), the first dermatology-specific health-related quality-of-life (HRQoL) instrument, has helped enormously to introduce and assess HRQoL in dermatology. Studies have shown that the DLQI captures specific information that is missed by generic HRQoL instruments such as the SF-36, illustrating the need for dermatology-specific questionnaires. Although the DLQI was designed for clinical dermatology practice (Finlay and Khan, 1994Finlay A.Y. Khan G.K. Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use.Clin Exp Dermatol. 1994; 19: 210-216Crossref PubMed Scopus (3167) Google Scholar), it is now used to reflect patients’ perspectives in important medical decision-making processes, such as treatment indications, reimbursement criteria, and treatment goals, and as an important outcome measure in observational and interventional research. If the stakes are this high, it could even be argued that disease-specific instruments may provide more precise and valuable information than dermatology-specific instruments (e.g., a psoriasis-specific HRQoL questionnaire may be better in selecting patients eligible for and monitoring the effects of a biological therapy than less specific dermatology tools). The DLQI’s ubiquity and impressive track record convey several advantages. Dermatologists are familiar with the DLQI; it has been accepted as the standard to measure HRQoL for dermatology patients by physicians, researchers, and regulatory agencies; it is available in many languages; and it may serve as a historical comparator. Moreover, it is reliable, valid, and easy to use. Nonetheless, these practical benefits (and people’s reluctance to change) should not outweigh important theoretical limitations (De Korte et al., 2002De Korte J. Mombers F.M. Sprangers M.A. et al.The suitability of quality-of-life questionnaires for psoriasis research: a systematic literature review.Arch Dermatol. 2002; 138: 1221-1227Crossref PubMed Google Scholar; Nijsten et al., 2006aNijsten T. Meads D.M. McKenna S.P. Dimensionality of the Dermatology Life Quality Index (DLQI): a commentary.Acta Derm Venereol. 2006; 86: 284-285Crossref PubMed Scopus (31) Google Scholar; Both et al., 2007Both H. Essink-Bot M.L. Busschbach J. et al.Critical review of generic and dermatology-specific health-related quality of life instruments.J Invest Dermatol. 2007; 127: 2726-2739Abstract Full Text Full Text PDF PubMed Scopus (214) Google Scholar; Twiss et al., 2012Twiss J. Meads D.M. Preston E.P. et al.Can we rely on the Dermatology Life Quality Index as a measure of the impact of psoriasis or atopic dermatitis?.J Invest Dermatol. 2012; 132: 76-84Abstract Full Text Full Text PDF PubMed Scopus (75) Google Scholar, this issue), especially when the continued use of this instrument may have far-reaching clinical and financial consequences. The DLQI’s questions focus on physical limitations, and few items address the frequent psychological impact of skin diseases, suggesting a low conceptual validity (Muldoon et al., 1998Muldoon M.F. Barger S.D. Flory J.D. et al.What are quality of life measurements measuring?.BMJ. 1998; 316: 542-545Crossref PubMed Scopus (347) Google Scholar). In practice, this implies that the DLQI is better at assessing the impact of severe (inflammatory) diseases than that of diseases with a relatively mild impact or with few physical symptoms but high psychological impact (such as vitiligo, alopecia areata, and basal cell carcinoma). Initially, the 10 questions were grouped into five scales without any formal statistical testing such as factor analysis, and a total score was advocated (Finlay and Khan, 1994Finlay A.Y. Khan G.K. Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use.Clin Exp Dermatol. 1994; 19: 210-216Crossref PubMed Scopus (3167) Google Scholar). This is a contradiction of terms: scales require separate scale scores and obviate an overall score. On the other hand, calculating a total score implies that the questions all address the same underlying construct (i.e., a unidimensional instrument) and that there are no scales. Formal factor analysis and Rasch analysis could not confirm the proposed (uni)dimensionality of the DLQI (McKenna et al., 2004McKenna S.P. Meads D.M. Doward L.C. Scaling properties of the Dermatology Life Quality Index (DLQI.Value Health. 2004; 7: 750-751Abstract Full Text PDF Google Scholar; Nijsten et al., 2006aNijsten T. Meads D.M. McKenna S.P. Dimensionality of the Dermatology Life Quality Index (DLQI): a commentary.Acta Derm Venereol. 2006; 86: 284-285Crossref PubMed Scopus (31) Google Scholar). Instruments that assess quality of life have evolved and continue to evolve. Instruments that assess quality of life have evolved and continue to evolve. The DLQI suffers from item bias (i.e., significant “differential item functioning”): the item responses of more than half of the questions are affected by external factors such as age, gender, diagnosis (as demonstrated in this issue by Twiss et al.), and nationality (Nijsten et al., 2006bNijsten T.E. Sampogna F. Chren M.M. et al.Testing and reducing Skindex-29 using Rasch analysis: Skindex-17.J Invest Dermatol. 2006; 126: 1244-1250Abstract Full Text Full Text PDF PubMed Scopus (96) Google Scholar, Nijsten et al., 2007Nijsten T. Meads D.M. de Korte J. Cross-cultural inequivalence of dermatology-specific health-related quality of life instruments in psoriasis patients.J Invest Dermatol. 2007; 127: 2315-2322Abstract Full Text Full Text PDF PubMed Scopus (70) Google Scholar), not solely by the level of HRQoL impairment. Theoretically, this implies that responses to the DLQI by old men and young women with a similar HRQoL impairment cannot be compared, that the scores for patients with psoriasis cannot be directly compared with those of patients with atopic dermatitis, and that Italian patients respond differently to some of the items than do Dutch patients. Although this may seem a theoretical concern at first, it becomes a real problem if the DLQI is used to assess the impact of a disease in heterogeneous patient populations, to compare HRQoL impairment between diseases, or as an outcome measure in large international clinical trials. In other studies, the Skindex-17 showed much less item bias for these factors, confirming the feasibility of achieving these desirable measurement properties (Nijsten et al., 2006bNijsten T.E. Sampogna F. Chren M.M. et al.Testing and reducing Skindex-29 using Rasch analysis: Skindex-17.J Invest Dermatol. 2006; 126: 1244-1250Abstract Full Text Full Text PDF PubMed Scopus (96) Google Scholar, Nijsten et al., 2007Nijsten T. Meads D.M. de Korte J. Cross-cultural inequivalence of dermatology-specific health-related quality of life instruments in psoriasis patients.J Invest Dermatol. 2007; 127: 2315-2322Abstract Full Text Full Text PDF PubMed Scopus (70) Google Scholar). Looking back at the past 20 years since the introduction of the DLQI, I see three generations of HRQoL instruments in dermatology. The DLQI is an example of first-generation instruments that were developed on an intuitive basis in the early days of dermatologic psychometric research. Items were often created and selected by the researchers based on existing tools, without input from patients. Several (classic test) psychometric properties were considered at the time of conception (e.g., validity and reliability), but others were evaluated only after its introduction (e.g., responsiveness, dimensionality, and item functioning). These instruments were not likely to be adjusted afterward. The second generation of instruments was developed using the psychometric knowledge available at the time. From a pool of items created in collaboration with psychologists and patients, statistical tests were used to select the items for the (pre)final instrument. Subsequent testing of the HRQoL instrument changed the (total number of) instruments’ items. The Skindex-29 is the best example of second-generation HRQoL instruments. In the past decade, the use of item response theory (IRT) models has expanded and is now considered the gold standard (McHorney, 1997McHorney C.A. Generic health measurement: past accomplishments and a measurement paradigm for the 21st century.Ann Intern Med. 1997; 127: 743-750Crossref PubMed Google Scholar; Tennant et al., 2004Tennant A. McKenna S.P. Hagell P. Application of Rasch analysis in the development and application of quality of life instruments.Value Health. 2004; 1: S22-6Abstract Full Text PDF Scopus (294) Google Scholar). In addition to the trinity of psychometric properties (validity, reliability, and responsiveness), third-generation instruments have been created using modeling that provides detailed information about dimensionality, response categories, and differential item functioning. None of the existing dermatology-specific HRQoL instruments can be considered a true third-generation tool, but several disease-specific questionnaires have been developed using IRT models (Whalley et al., 2004Whalley D. McKenna S.P. Dewar A.L. et al.A new instrument for assessing quality of life in atopic dermatitis: international development of the Quality of Life Index for Atopic Dermatitis (QoLIAD.Br J Dermatol. 2004; 150 (274-83)Crossref PubMed Scopus (94) Google Scholar). Several attempts have been made to upgrade existing instruments. A more in-depth analysis of the properties of the DLQI does not make it a second-generation instrument if it is not adjusted accordingly. Likewise, applying Rasch analysis, a one-parameter IRT model, to first- and second-generation instruments does not make these instruments third generation. Applying the Rasch model to the Skindex-29 demonstrated that the 29 items did not fit the model, but after the developers deleted 12 items, creating two scales instead of three, and regrouping the response categories, the Skindex did fit the model and has been renamed the Skindex-17 (Nijsten et al., 2007Nijsten T. Meads D.M. de Korte J. Cross-cultural inequivalence of dermatology-specific health-related quality of life instruments in psoriasis patients.J Invest Dermatol. 2007; 127: 2315-2322Abstract Full Text Full Text PDF PubMed Scopus (70) Google Scholar). The current study by Twiss et al., 2012Twiss J. Meads D.M. Preston E.P. et al.Can we rely on the Dermatology Life Quality Index as a measure of the impact of psoriasis or atopic dermatitis?.J Invest Dermatol. 2012; 132: 76-84Abstract Full Text Full Text PDF PubMed Scopus (75) Google Scholar confirms preliminary findings of previous studies demonstrating that the DLQI has several intrinsic limitations that cannot be solved by adjusting this instrument. Interestingly, the Cardiff research group that developed the DLQI is now using Rasch analysis in the creation of new HRQoL questionnaires (Basra et al., 2011Basra M. Zammit A.M. Salek S. et al.Application of Rasch analysis to Psoriasis Family Index (PFI)—a novel psoriasis-specific quality of life instrument for family members and partners of psoriasis patients.J Invest Dermatol. 2011; 131 (S49)Google Scholar), confirming the acceptance of this theoretical framework as the way forward in (dermatologic) HRQoL and patient-reported-outcome research. For now, the Skindex-29 (or -17) is the preferred dermatology-specific instrument, but it is time to raise the bar for HRQoL and other patient-reported-outcome instruments used to assess patients’ experiences. The fast-growing importance of these measures in medicine is a big step forward, but their growing importance obliges us to create and use the best available instruments. This responsibility requires dedicated experts performing methodological HRQoL research and a community willing to reach higher than before." @default.
• W1999647535 created "2016-06-24" @default.
• W1999647535 creator A5003599279 @default.
• W1999647535 date "2012-01-01" @default.
• W1999647535 modified "2023-10-02" @default.
• W1999647535 title "Dermatology Life Quality Index: Time to Move Forward" @default.
• W1999647535 cites W1973701700 @default.
• W1999647535 cites W1989418564 @default.
• W1999647535 cites W2022926448 @default.
• W1999647535 cites W2028535337 @default.
• W1999647535 cites W2059542225 @default.
• W1999647535 cites W2065401305 @default.
• W1999647535 cites W2090735611 @default.
• W1999647535 cites W2093203143 @default.
• W1999647535 cites W2096991001 @default.
• W1999647535 cites W2106916609 @default.
• W1999647535 cites W2128166333 @default.
• W1999647535 cites W2158263460 @default.
• W1999647535 doi "https://doi.org/10.1038/jid.2011.354" @default.
• W1999647535 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/22158607" @default.
• W1999647535 hasPublicationYear "2012" @default.
• W1999647535 type Work @default.
• W1999647535 sameAs 1999647535 @default.
• W1999647535 citedByCount "74" @default.
• W1999647535 countsByYear W19996475352012 @default.
• W1999647535 countsByYear W19996475352013 @default.
• W1999647535 countsByYear W19996475352014 @default.
• W1999647535 countsByYear W19996475352015 @default.
• W1999647535 countsByYear W19996475352016 @default.
• W1999647535 countsByYear W19996475352017 @default.
• W1999647535 countsByYear W19996475352018 @default.
• W1999647535 countsByYear W19996475352019 @default.
• W1999647535 countsByYear W19996475352020 @default.
• W1999647535 countsByYear W19996475352021 @default.
• W1999647535 countsByYear W19996475352022 @default.
• W1999647535 countsByYear W19996475352023 @default.
• W1999647535 crossrefType "journal-article" @default.
• W1999647535 hasAuthorship W1999647535A5003599279 @default.
• W1999647535 hasBestOaLocation W19996475351 @default.
• W1999647535 hasConcept C121332964 @default.
• W1999647535 hasConcept C136764020 @default.
• W1999647535 hasConcept C16005928 @default.
• W1999647535 hasConcept C2776173921 @default.
• W1999647535 hasConcept C2777382242 @default.
• W1999647535 hasConcept C2779530757 @default.
• W1999647535 hasConcept C2780564577 @default.
• W1999647535 hasConcept C41008148 @default.
• W1999647535 hasConcept C62520636 @default.
• W1999647535 hasConcept C71924100 @default.
• W1999647535 hasConceptScore W1999647535C121332964 @default.
• W1999647535 hasConceptScore W1999647535C136764020 @default.
• W1999647535 hasConceptScore W1999647535C16005928 @default.
• W1999647535 hasConceptScore W1999647535C2776173921 @default.
• W1999647535 hasConceptScore W1999647535C2777382242 @default.
• W1999647535 hasConceptScore W1999647535C2779530757 @default.
• W1999647535 hasConceptScore W1999647535C2780564577 @default.
• W1999647535 hasConceptScore W1999647535C41008148 @default.
• W1999647535 hasConceptScore W1999647535C62520636 @default.
• W1999647535 hasConceptScore W1999647535C71924100 @default.
• W1999647535 hasIssue "1" @default.
• W1999647535 hasLocation W19996475351 @default.
• W1999647535 hasLocation W19996475352 @default.
• W1999647535 hasOpenAccess W1999647535 @default.
• W1999647535 hasPrimaryLocation W19996475351 @default.
• W1999647535 hasRelatedWork W1603648899 @default.
• W1999647535 hasRelatedWork W1982389640 @default.
• W1999647535 hasRelatedWork W2379977052 @default.
• W1999647535 hasRelatedWork W2604173742 @default.
• W1999647535 hasRelatedWork W2800869485 @default.
• W1999647535 hasRelatedWork W2905568634 @default.
• W1999647535 hasRelatedWork W3121252746 @default.
• W1999647535 hasRelatedWork W4211257319 @default.
• W1999647535 hasRelatedWork W4255752390 @default.
• W1999647535 hasRelatedWork W4297184974 @default.
• W1999647535 hasVolume "132" @default.
• W1999647535 isParatext "false" @default.
• W1999647535 isRetracted "false" @default.
• W1999647535 magId "1999647535" @default.
• W1999647535 workType "article" @default.