The Atopic Dermatitis Quickscore (ADQ): validation of a new parent-administered atopic dermatitis scoring tool

Background Atopic dermatitis (AD) severity is assessed using relatively elaborate scoring systems administered by health care practitioners; modification for parent assessment or self-assessment is limited. For ongoing home-based evaluation of pediatric AD treatment and outcomes, a quick, easy-to-use, parent-administered scoring tool is essential. Objective To evaluate the validity and responsiveness to change of the Atopic Dermatitis Quickscore (ADQ) compared with the established, widely used Scoring Atopic Dermatitis Severity Index (SCORAD). Methods The ADQ was developed for parent report and was validated against the SCORAD. The SCORAD assesses percentage of body surface area involved, intensity of a “representative area,” pruritus, and insomnia. The ADQ assesses involvement and pruritus of 7 body parts. Sixty-eight children entering a pediatric day treatment program for moderate to severe AD were recruited. Skin severity was scored at admission by a physician assistant using the SCORAD and by a parent using the ADQ. Pearson correlations of the 2 scales were assessed. Results The ADQ total score correlates with the SCORAD total score ( r = 0.64, P < .001). The ADQ pruritus score correlates with the SCORAD pruritus score ( r = 0.62, P < .001). Correlation at the end of treatment was also seen for ADQ and SCORAD total and pruritus scores ( r = 0.39, P = .02, and r = 0.66, P < .001, respectively). Responsiveness of both scales to change in skin condition was demonstrated, with significant decreases in total and pruritus scores ( P < .001). Conclusions The parent-administered ADQ takes 5 minutes to complete. Scores from the ADQ and the SCORAD are well correlated and are responsive to changes in skin condition, supporting the validity of the ADQ.