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. 2023 Jun 27:16:206-213.
doi: 10.1016/j.jdin.2023.06.008. eCollection 2024 Sep.

Reliability of the Vitiligo Area Scoring Index measurement tool for vitiligo

Aunna Pourang  1 , Indermeet Kohli  1   2 , Nneamaka Ezekwe  1   3 , Angela Parks-Miller  1 , Tasneem F Mohammad  1 , Richard H Huggins  1 , Henry W Lim  1 , Linda S Deal  4 , Tatjana Lukic  4 , Fan Zhang  5 , Iltefat Hamzavi  1
Affiliations

Reliability of the Vitiligo Area Scoring Index measurement tool for vitiligo

Aunna Pourang et al. JAAD Int. .

Abstract

Background: A reliable instrument is needed to assess vitiligo severity and treatment response.

Objective: To assess inter- and intrarater variability and accuracy of the Vitiligo Area Scoring Index among trained raters and to evaluate a proposed Vitiligo Area Scoring Index using equidistant 10% depigmentation increments (VASI 10%).

Methods: In this prospective study, 12 raters evaluated images of 10 participants with vitiligo on 2 occasions using total body Vitiligo Area Scoring Index (T-VASI) and facial Vitiligo Area Scoring Index (F-VASI) scores after training. Inter- and intrarater reliabilities and accuracy vs digital scores were determined using intraclass correlation coefficients. VASI 10% scores were evaluated separately for interrater reliability and accuracy.

Results: F-VASI interrater reliability improved from "moderate" to "good" between time points, while T-VASI was "good" at both time points. Intrarater reliability ranged from "good" to "excellent" for T-VASI and "poor" to "excellent" for F-VASI. Accuracy intraclass correlation coefficient was "good" to "excellent" for most raters. Interrater reliability using VASI 10% was "moderate" for both T-VASI and F-VASI.

Limitations: Small participant population and number of raters; participants were not assessed in person; no repeated VASI 10% measures.

Conclusion: Vitiligo Area Scoring Index generally provides good to excellent reliability for assessment of vitiligo by raters who receive standardized training.

Keywords: VASI; VASI 10%; measurement tool; reliability; reproducibility; validation; validity; vitiligo.

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Conflict of interest statement

Dr Kohli has served as an investigator for Ferndale, Estée Lauder, La Roche Posay Dermatologique, Unigen, Johnson and Johnson, Allergan, Pfizer, and Bayer; has received support from the American Skin Association for a vitiligo project; has served as a consultant for Pfizer, Johnson and Johnson, Beiersdorf (previously known as Bayer), and ISDIN; and has received salary support from the Dermatology Foundation through a research career development award. Dr Mohammad has served as an investigator for Avita Medical, Clinuvel, Pfizer, Incyte, National Institute for Allergy and Immunology, Ferndale Laboratories, Estée Lauder, Johnson and Johnson, and Allergan; and has received honoraria as an advisory board member for Ferndale Laboratories. Dr Huggins is an investigator for Pfizer, Incyte, Arcutis, Clinuvel, and the Immune Tolerance Network. Dr Lim is an investigator for Incyte, L’Oréal, Pfizer, and PCORI; is a consultant for Pierre Fabre, ISDIN, La Roche-Posay, and Beiersdorf; and has served as a speaker for educational sessions for La Roche-Posay, Cantabria Labs, Pierre Fabre, and Bioderma. Author Deal, and Dr Lukic are employees of Pfizer, Inc and hold shares in Pfizer, Inc. Dr Zhang was an employee of Pfizer, Inc, at the time of this analysis and holds shares in Pfizer, Inc. Dr Hamzavi received honoraria as an advisory board member for Aclaris and is a consultant and investigator for Pfizer, Abbvie, Incyte, Avita, and Clinuvel. Dr Pourang, Dr Ezekwe, and Author Parks-Miller have no conflicts of interest to declare.

Figures

Fig 1
Fig 1
Design of the studies. VASI, Vitiligo Area Scoring Index; VASI 10%, Vitiligo Area Scoring Index using equidistant 10% depigmentation increments.
Fig 2
Fig 2
Comparison of lesion depigmentation intervals used in the assessment of Vitiligo Area Scoring Index and Vitiligo Area Scoring Index using equidistant 10% depigmentation increments. VASI, Vitiligo Area Scoring Index; VASI 10%, Vitiligo Area Scoring Index using equidistant 10% depigmentation increments.
See this image and copyright information in PMC

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