A systematic review of the use of quality‐of‐life instruments in randomized controlled trials for psoriasis. (12th October 2016)

• Record Type: Journal Article
• Authors: Ali, F.M.; Cueva, A.C.; Vyas, J.; Atwan, A.A.; Salek, M.S.; Finlay, A.Y.; Piguet, V.
• Is Part Of: British journal of dermatology. Volume 176:Number 3(2017)
• Page Start: 577
• Page End: 593
• Publication Date: 2016-10-12
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.14788
• Languages: English
• ISSNs: 0007-0963

Abstract

Abstract : What's already known about this topic? Psoriasis significantly impacts quality of life (QoL) in patients. Generic, skin‐specific and disease‐specific instruments are used in psoriasis interventional studies. In psoriasis randomized controlled trials (RCTs), biologics are the most researched interventions for which QoL is reported. What does this study add? The most commonly used QoL instruments in psoriasis RCTs are the Dermatology Life Quality Index, 36‐Item Short Form Survey and EuroQol‐5D. There is an increasing use of QoL instruments in RCTs in psoriasis. The minimal clinically important difference of QoL measure scores is under‐reported. There is inconsistent reporting of QoL data and a need for guidelines when reporting. Linked Comment: Kivelevitch et al. Br J Dermatol 2017;176 :563 . Summary: Planners of interventional studies in psoriasis face the dilemma of selecting suitable quality‐of‐life (QoL) measures. Systematic reviews have the potential of identifying psychometrically sound measures in a given therapeutic area, while guiding the development of practice guidelines. The aim of this systematic review was to generate evidence of the use of QoL instruments in randomized controlled trials (RCTs) for interventions in psoriasis. The methodology followed the PRISMA guidelines. Six databases were searched with 388 search terms. Abstracts of articles were reviewed independently by two assessors, and a third adjudicator resolved any opinion differences. Risk of bias was assessed using the Jadad scale. Of 3646 screened publications, 99 articles (100 trials) met the eligibility criteria for inclusion, describing research on 33 215 patients. Thirty‐three trials tested topical therapy, 18 systemic, 39 biologics, nine phototherapy and 10 other interventions. The Dermatology Life Quality Index (DLQI) was the most commonly used QoL instrument (83 studies, 83%), followed by the 36‐Item Short Form Survey (SF‐36) (31, 31%), EuroQoL‐5D (EQ‐5D) (15, 15%), Psoriasis Disability Index (14, 14%) and Skindex (five, 5%). There was widespread inconsistency in the way that QoL data were reported. Of the 100 trials identified, 37 reported minimal clinically important difference (MCID): 32 for DLQI, 10 for SF‐36 and six for EQ‐5D. QoL measurement is increasingly being reported in RCTs of psoriasis. Formal guidelines are needed for assessment and publishing of QoL data. Researchers should consider whether MCID information is available, and development of MCID data should be encouraged.