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Measuring Atopic Eczema Control and Itch Intensity in Clinical Practice: A Consensus Statement from the Harmonising Outcome Measures for Eczema in Clinical Practice (HOME-CP) Initiative

Leshem, Yael A; Chalmers, Joanne R; Apfelbacher, Christian; Katoh, Norito; Gerbens, Louise AA; Schmitt, Jochen; Spuls, Phyllis I; Thomas, Kim S.; Howells, Laura; Williams, Hywel C.; Simpson, Eric L


Yael A Leshem

Joanne R Chalmers

Christian Apfelbacher

Norito Katoh

Louise AA Gerbens

Jochen Schmitt

Phyllis I Spuls

Senior Research Fellow

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Professor of Dermato-Epidemiology

Eric L Simpson


Importance: Measuring outcomes in clinical practice can aid patient care, quality improvement, and real-world evidence generation. The Harmonising Outcome Measures for Eczema (HOME) Clinical Practice initiative is developing a list of validated, feasible instruments to measure atopic eczema in clinical care. Prior work identified symptoms and long-term control as the most important domains to measure in clinical practice. The Patient-Oriented Eczema Measure (POEM) and the Patient-Oriented Scoring Atopic Dermatitis Index (PO-SCORAD) were recommended by consensus to measure symptoms in clinical practice, but a need for instruments to measure itch intensity specifically was recognized. The HOME group also previously decided that long-term control should be captured by repeated measurements of eczema control. Recommended instruments to measure eczema control in clinical practice have not been defined. Objective: To recommend instruments to measure eczema control and itch intensity in patients with atopic eczema in clinical practice. Evidence Review: Available instruments to measure eczema control and itch intensity were identified through systematic reviews, informing a consensus process held at the HOME VIII virtual online meeting (October 6 and October 9, 2020). Feasibility aspects were highlighted to optimize instrument selection for the clinical practice. Consensus on an instrument was reached if fewer than 30% of the voters disagreed. Findings: Of 7 identified instruments, the Recap of Atopic Eczema (RECAP) and Atopic Dermatitis Control Tool (ADCT) were the recommended instruments to measure eczema control (3 of 63 [5%] and 7 of 69 [10%] of voters disagreed, respectively). A single-question patient global assessment garnered support, but the current available instrument did not reach consensus. Six available itch-intensity instruments were identified. Of them, 3 instruments were recommended by consensus: a peak 24-hour numeric rating scale (NRS)-itch, and 1-week NRS-itch instruments from the Patient-Reported Outcomes Measurement Information System (PROMIS) Itch Questionnaire, measuring average and peak itch (11 of 63 [17%], 14 of 63 [22%], and 16 of 59 [27%] voters disagreed, respectively). Conclusions and Relevance: Clinicians and patients are encouraged to incorporate these well-validated, quick-to-perform, and easy-to-use instruments into their clinic, selecting the instruments that best fit their need. These assessments are meant to enhance, not replace, the patient-clinician encounter, and to support real-world research and health care improvement..


Leshem, Y. A., Chalmers, J. R., Apfelbacher, C., Katoh, N., Gerbens, L. A., Schmitt, J., …Simpson, E. L. (2022). Measuring Atopic Eczema Control and Itch Intensity in Clinical Practice: A Consensus Statement from the Harmonising Outcome Measures for Eczema in Clinical Practice (HOME-CP) Initiative. JAMA Dermatology, 158(12), 1429-1435.

Journal Article Type Article
Acceptance Date Aug 9, 2022
Online Publication Date Oct 12, 2022
Publication Date 2022-12
Deposit Date Aug 18, 2022
Journal JAMA Dermatology
Print ISSN 2168-6068
Electronic ISSN 2168-6084
Peer Reviewed Peer Reviewed
Volume 158
Issue 12
Pages 1429-1435
Keywords Dermatology
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