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Development and initial testing of a new instrument to measure the experience of eczema control in adults and children: Recap of atopic eczema (RECAP)

Howells, L. M.; Chalmers, J. R.; Gran, S.; Ahmed, A.; Apfelbacher, C.; Burton, T.; Howie, L.; Lawton, S.; Ridd, M. J.; Rogers, N. K.; Sears, A. V.; Spuls, P.; von Kobyletzki, L.; Thomas, K. S.

Development and initial testing of a new instrument to measure the experience of eczema control in adults and children: Recap of atopic eczema (RECAP) Thumbnail


Authors

LAURA HOWELLS LAURA.HOWELLS1@NOTTINGHAM.AC.UK
Senior Research Fellow

J. R. Chalmers

SONIA GRAN SONIA.GRAN@NOTTINGHAM.AC.UK
Associate Professor

A. Ahmed

C. Apfelbacher

T. Burton

L. Howie

S. Lawton

M. J. Ridd

N. K. Rogers

A. V. Sears

P. Spuls

L. von Kobyletzki



Abstract

Background: Eczema control has been identified as an important outcome by key stakeholders in eczema research (including patients, carers, healthcare professionals and researchers) but no validated instruments for the domain have been identified. Objectives: To develop a measurement instrument to capture a patient's perspective of eczema control that is suitable for use in eczema clinical trials. Methods: Best practice for the development of a patient-reported outcome was followed. A mixed-methods approach was used to develop and refine a conceptual framework, generate, refine and select items and to test the distribution and construct validity of the final scale. The mixed-methods approach involved expert panel meetings (including patient representatives, healthcare professionals and methodologists), and data collection using a focus group, cognitive interviews and an online survey with people with eczema and caregivers. Multivariable linear regression was used in the item selection process. Results: Fourteen expert panel members co-produced the instrument, with input from people with eczema and caregivers via a focus group (n = 6), cognitive interviews (n = 13) and an online survey (n = 330). The resulting instrument, Recap of atopic eczema (RECAP), is a seven-item questionnaire that captures eczema control via self or caregiver report. The development process aimed to ensure good content validity and feasibility. Initial testing suggested no floor or ceiling effects and good construct validity. Hypothesized correlation with the Patient-Oriented Eczema Measure was confirmed [r(258) = 0·83, P < 0·001]. Conclusions: RECAP has the potential to improve reporting of eczema control in research and clinical practice. Further exploration of measurement properties is required. Linked Comment:Pattinson and Bundy. Br J Dermatol 2020; 183:418–419. What's already known about this topic?. Eczema control has been identified as an important outcome by key stakeholders in eczema research (including patients, carers, healthcare professionals and researchers). Qualitative studies suggest eczema control is a multifaceted and individual experience and no instrument has been identified that captures eczema control in this way. What does this study add?. We have developed Recap of atopic eczema (RECAP), a seven-item questionnaire to capture the experience of eczema control in all ages and eczema severities; there are two versions: a self-reported version for adults and older children with eczema, and a caregiver-reported version for younger children with eczema. Designed with input from people with eczema, caregivers and healthcare professionals to ensure good content validity. Initial testing of score distributions and construct validity suggests good measurement properties. What are the clinical implications of the work?. The RECAP instrument is appropriate and feasible for measuring eczema control in clinical trials and may also be useful in routine practice.

Journal Article Type Article
Acceptance Date Dec 2, 2019
Online Publication Date Dec 3, 2019
Publication Date Sep 1, 2020
Deposit Date Dec 20, 2019
Publicly Available Date Dec 4, 2020
Journal British Journal of Dermatology
Print ISSN 0007-0963
Electronic ISSN 1365-2133
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 183
Issue 3
Pages 524-536
DOI https://doi.org/10.1111/bjd.18780
Public URL https://nottingham-repository.worktribe.com/output/3606675
Publisher URL https://onlinelibrary.wiley.com/doi/abs/10.1111/bjd.18780
Additional Information This is the peer reviewed version of the following article: Howells, L., Chalmers, J., Gran, S., Ahmed, A., Apfelbacher, C., Burton, T., Howie, L., Lawton, S., Ridd, M., Rogers, N., Sears, A., Spuls, P., von Kobyletzki, L. and Thomas, K. (2019), Development and initial testing of a new instrument to measure the experience of eczema control in adults and children: Recap of atopic eczema (RECAP). Br J Dermatol, which has been published in final form at https://doi.org/10.1111/bjd.18780
. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.