A Quality Analysis of the Measurement Properties of the Clinician-Reported Outcome Measures for Vitiligo and of the Studies Assessing Them: A Systematic Review
Authors:
Duponselle, J., Herbelet, S., Delbaere, L., De Schryver, Z., Forman, M., Terwee, C. B., Wolkerstorfer, A., Seneschal, J., Spuls, P. I., Garg, A., Hamzavi, I., Speeckaert, R., and van Geel, N.
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.