Dermatitis : contact, atopic, occupational, drug · 2026
Validation of Head and Neck EASI Severity Strata Against vIGA-AD in Atopic Dermatitis.
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Rønnstad Amalie Thorsti Møller, Andersen Yuki M F, Hærskjold Ann, Søndergaard Marianne Baastrup, Nielsen Mia-Louise, Karmisholt Katrine Elisabeth, Simonsen Anne Birgitte, Danielsen Anne G, Strauss Gitte, Idorn Luise W, Hald Marianne, Kofoed Kristian, Cvetkovski Rikke Skøt, Ammitzbøll Elisabeth, Mølenberg David, Ring Hans Christian, Themstrup Lotte, Mortz Charlotte G, Deleuran Mette, Zachariae Claus, Vestergaard Christian, Thomsen Simon Francis, Egeberg Alexander, Ibler Kristina S, Thyssen Jacob P
Аннотация
BACKGROUND: Head-and-neck (H&N) Eczema Area and Severity Index (EASI) sub-scores are increasingly reported, but their clinical interpretation relative to the validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD) remains unclear.
OBJECTIVE: Define H&N EASI severity strata anchored to vIGA-AD and evaluate convergent validity and interrater reliability.
METHODS: Twenty-two dermatologists evaluated photographs of 21 patients with H&N AD using the H&N EASI and vIGA-AD. H&N EASI severity strata were derived based on the empirical distribution within vIGA-AD. Kendall's tau (τ) and Spearman's correlation coefficient (SCC) assessed convergent validity, and intraclass correlation coefficients (ICC) evaluated interrater reliability.
RESULTS: H&N EASI scores aligned with vIGA-AD (0, "Clear"; 0.1-0.6, "Almost clear"; 0.7-1.7, "Mild"; 1.8-3.0, "Moderate"; and 3.1-4.8, "Severe"), showing almost perfect agreement (weighted Cohen's κ = 0.83 [95% CI, 0.80-0.86], P < 0.001). H&N EASI and vIGA-AD scores were strongly correlated (τ = 0.74 [95% CI, 0.71-0.77]; SCC = 0.86 [95% CI, 0.83-0.88], both P < 0.001). Interrater reliability was moderate for H&N EASI (0.73 [95% CI, 0.60-0.85]) and vIGA-AD (0.61 [95% CI, 0.46-0.77]) (both P < 0.001).
CONCLUSIONS: H&N EASI severity strata provide a reliable and clinically meaningful assessment of H&N AD, aligning with facial vIGA-AD and enabling evaluation beyond global assessment.
OBJECTIVE: Define H&N EASI severity strata anchored to vIGA-AD and evaluate convergent validity and interrater reliability.
METHODS: Twenty-two dermatologists evaluated photographs of 21 patients with H&N AD using the H&N EASI and vIGA-AD. H&N EASI severity strata were derived based on the empirical distribution within vIGA-AD. Kendall's tau (τ) and Spearman's correlation coefficient (SCC) assessed convergent validity, and intraclass correlation coefficients (ICC) evaluated interrater reliability.
RESULTS: H&N EASI scores aligned with vIGA-AD (0, "Clear"; 0.1-0.6, "Almost clear"; 0.7-1.7, "Mild"; 1.8-3.0, "Moderate"; and 3.1-4.8, "Severe"), showing almost perfect agreement (weighted Cohen's κ = 0.83 [95% CI, 0.80-0.86], P < 0.001). H&N EASI and vIGA-AD scores were strongly correlated (τ = 0.74 [95% CI, 0.71-0.77]; SCC = 0.86 [95% CI, 0.83-0.88], both P < 0.001). Interrater reliability was moderate for H&N EASI (0.73 [95% CI, 0.60-0.85]) and vIGA-AD (0.61 [95% CI, 0.46-0.77]) (both P < 0.001).
CONCLUSIONS: H&N EASI severity strata provide a reliable and clinically meaningful assessment of H&N AD, aligning with facial vIGA-AD and enabling evaluation beyond global assessment.