Nail Assessment in Psoriasis and Psoriatic Arthritis (NAPPA): development and validation of a tool for assessment of nail psoriasis outcomes. (March 2014)

• Record Type: Journal Article
• Authors: Augustin, M.; Blome, C.; Costanzo, A.; Dauden, E.; Ferrandiz, C.; Girolomoni, G.; Gniadecki, R.; Iversen, L.; Menter, A.; Michaelis‐Wittern, K.; Morita, A.; Nakagawa, H.; Reich, K.
• Is Part Of: British journal of dermatology. Volume 170:Number 3(2014:Mar.)
• Page Start: 591
• Page End: 598
• Publication Date: 2014-03
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.12664
• Languages: English
• ISSNs: 0007-0963

Abstract

<abstract abstract-type="main" id="bjd12664-abs-0001"> <title>Summary</title> <sec id="bjd12664-sec-0001" sec-type="section"> <title>Background</title> <p>Existing tools for nail psoriasis are complex and may not adequately measure outcomes that are important to patients.</p> </sec> <sec id="bjd12664-sec-0002" sec-type="section"> <title>Objectives</title> <p>We have developed and validated a new tool, the Nail Assessment in Psoriasis and Psoriatic Arthritis (NAPPA), with three components: a questionnaire assessing quality of life (NAPPA‐QoL), a two‐part questionnaire assessing patient‐relevant treatment benefits (the Patient Benefit Index, NAPPA‐PBI) and a psoriasis Clinical Assessment of Severity (NAPPA‐CLIN).</p> </sec> <sec id="bjd12664-sec-0003" sec-type="section"> <title>Methods</title> <p>Development of the questionnaires involved multiple steps: (i) collection of items about nail psoriasis‐related impairments and treatment goals; (ii) selection of 48 items by an expert panel, including patients; (iii) translation into eight languages; (iv) feasibility testing and (v) longitudinal validation in six countries.</p> </sec> <sec id="bjd12664-sec-0004" sec-type="section"> <title>Results</title> <p>Patients found the questionnaires clear (84%) and comprehensible (95%). NAPPA‐QoL and NAPPA‐PBI scores correlated moderately with clinical outcomes [e.g. Nail Psoriasis Severity Index (NAPSI)] and markedly with other quality‐of‐life questionnaires (e.g. EQ‐5D™). Both questionnaires were sensitive to change. Internal consistency was good (Cronbach α ≥ 0·88 for all scales). The NAPPA‐CLIN, a brief version of NAPSI that involves assessment of only four digits rather than all 20, was found to correlate highly with total NAPSI score (<italic>r </italic>=<italic> </italic>0·97, <italic>P </italic><<italic> </italic>0·001).</p> </sec> <sec id="bjd12664-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Overall, the three‐component NAPPA tool is a valid, reliable and practical instrument to assess patient‐relevant nail psoriasis outcomes.</p> </sec> </abstract>