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Review
. 2025 Apr 8;14(8):2548.
doi: 10.3390/jcm14082548.

A Quality Analysis of the Measurement Properties of the Clinician-Reported Outcome Measures for Vitiligo and of the Studies Assessing Them: A Systematic Review

Jolien Duponselle  1 , Sandrine Herbelet  1 , Liesbeth Delbaere  1 , Zoë De Schryver  1 , Maxine Forman  1 , Caroline B Terwee  2   3 , Albert Wolkerstorfer  4 , Julien Seneschal  5   6 , Phyllis I Spuls  4 , Amit Garg  7 , Iltefat Hamzavi  8 , Reinhart Speeckaert  1 , Nanja van Geel  1
Affiliations
Review

A Quality Analysis of the Measurement Properties of the Clinician-Reported Outcome Measures for Vitiligo and of the Studies Assessing Them: A Systematic Review

Jolien Duponselle et al. J Clin Med. .

Abstract

Background/Objective: Evaluating the measurement properties (MPs) of Clinician-Reported Outcome Measures (ClinROMs) is crucial for selecting appropriate instruments for vitiligo assessment. This review critically appraises the existing evidence on the MPs of the ClinROMs used in vitiligo. Methods: A systematic search was conducted in PubMed, Embase, and the Cochrane Library up to 20 February 2024, identifying validated ClinROMs in vitiligo. Studies were included if they provided original data on ClinROM development or analysis, excluding those solely validating other instruments. The assessment of ClinROM quality and risk of bias analysis followed COSMIN guidelines, and ClinROMs with the highest number of sufficiently rated MPs supported by a moderate/high Quality of Evidence (QoE) were identified per construct category (extent/repigmentation and evolution/activity). Results: This review included 22 studies evaluating 12 ClinROMs. For extent/repigmentation, the Vitiligo Area and Severity Index (VASI), Vitiligo Extent Score (VES), and VESplus each had four MPs rated sufficient with a moderate/high QoE. For evolution, the Vitiligo Disease Improvement Score (VDIS) and Vitiligo Disease Activity Score (VDAS) similarly had four MPs rated sufficient with a moderate/high QoE. For activity evaluated based on a single time point, the Vitiligo Signs of Activity Score (VSAS), the only validated ClinROM for visible signs of disease activity, had three MPs rated sufficient with a moderate/high QoE. Conclusions: Six ClinROMs demonstrated the highest quality ratings across two key constructs. However, none underwent a complete evaluation of all their MPs, highlighting the need for further validation and refinement.

Keywords: COSMIN guidelines; clinician-reported outcome measures; measurement properties; vitiligo.

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Conflict of interest statement

Nanja van Geel: Consultant and/or investigator: Pfizer, Incyte, Bristol Meyers, AbbVie, Idorsia and MSD/Merck. Nanja van Geel and Reinhart Speeckaert were involved in the development and/or validation of several ClinROMs analyzed in this review. Phyllis Spuls has received departmental independent research grants for the TREAT NL registry from Pharma since December 2019, is Chief Investigator (CI) of the systemic and phototherapy atopic eczema registry (TREAT NL/BE) for adults and children, and is the project lead of the government-funded UPDATE trial. She is involved in performing clinical trials with many pharmaceutical industries that manufacture drugs used for the treatment of, e.g., psoriasis and atopic dermatitis, for which financial compensation is paid to the department/hospital. She was involved in the development of one of the HOME core outcome instruments (recap of atopic eczema (RECAP)), and in the development of the Outcome Measures for VAscular Malformations (OVAMA) questionnaire for vascular malformations. Amit Garg is an advisor for AbbVie, Boehringer Ingelheim, Incyte, Insmed, Novartis, Pfizer, Sonoma Biotherapeutics, UCB, Union Therapeutics, and receives honoraria. Amit Garg receives research grants from AbbVie, UCB, and CHORD COUSIN Collaboration (C3). He is a co-copyright holder of the HS-IGA and HiSQOL instruments.

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