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. 2021 May;184(5):905-912.
doi: 10.1111/bjd.19565. Epub 2020 Dec 30.

Hidradenitis Suppurativa Area and Severity Index Revised (HASI-R): psychometric property assessment

N Goldfarb  1   2 , M A Lowes  3 , M Butt  4 , T King  4 , A Alavi  5 , J S Kirby  4
Affiliations

Hidradenitis Suppurativa Area and Severity Index Revised (HASI-R): psychometric property assessment

N Goldfarb et al. Br J Dermatol. 2021 May.

Abstract

Background: Validated, reliable, globally accepted outcome measurement instruments for hidradenitis suppurativa (HS) are needed. Current tools to measure the physical signs domain for HS rely on lesion counts, which are time-consuming and unreliable.

Objectives: To assess the reliability and validity of the Hidradenitis suppurativa Area and Severity Index Revised (HASI-R) tool, a novel method for assessing HS severity, incorporating signs of inflammation and body surface area involved.

Methods: The measurement properties of the HASI-R tool were evaluated. The tool was created by combining the previously published HASI and Severity and Area Score for Hidradenitis instruments. Twenty raters evaluated 15 patients with HS in a hospital-based ambulatory dermatology clinic. The objectives of the study were to assess inter- and intra-rater reliability of the HASI-R and its components, as well as its construct and known-groups validity. Existing lesion count-based clinician-reported measures of HS and their components were also assessed. Raters were also asked their preferences regarding the various HS severity assessment tools.

Results: The HASI-R had moderate inter-rater reliability [intra-class correlation coefficients (ICC) 0·60]. This was better than all other HS physical sign outcome measures evaluated, which had poor inter-rater reliability (ICC < 0·5). HASI-R had the highest intra-rater reliability (ICC 0·91). The HASI-R had good construct validity and demonstrated known-groups validity. The HASI-R was also the most preferred tool by all raters.

Conclusions: Results from the clinometric assessment of the HASI-R are encouraging, and support continued evaluation of this clinician-reported outcome measure.

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Figures

Figure 1.
Figure 1.
Known groups validity of HASI-R across IHS4 score groups
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References

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