DLQI-R Scoring Improves the Discriminatory Power of the Dermatology Life Quality Index in Patients with Psoriasis, Pemphigus and Morphea

Rencz, F. and Gulácsi, L. and Péntek, M. and Szegedi, A. and Remenyik, É. and Bata-Csörgő, Zs. and Bali, G. and Hidvégi, B. and Tamási, B. and Poór, A. K. and Hajdu, K. and Holló, P. and Kinyó, Á. and Sárdy, M. and Brodszky, V. (2020) DLQI-R Scoring Improves the Discriminatory Power of the Dermatology Life Quality Index in Patients with Psoriasis, Pemphigus and Morphea. BRITISH JOURNAL OF DERMATOLOGY, 182 (5). pp. 1167-1175. ISSN 0007-0963 (print); 1365-2133 (online)

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Abstract

Dermatology Life Quality Index (DLQI) rates 'not relevant' responses (NRRs) as the item of the questionnaire having no impact on the patients' lives at all. DLQI-R is a recently developed scoring that adjusts the total score of the questionnaire for the number of NRRs indicated by a patient.To compare the discriminatory power of the original and DLQI-R scoring approaches in terms of absolute and relative informativity.Cross-sectional data of 637 patients with morphea, pemphigus and psoriasis were used for the analyses. To assess absolute and relative informativity, Shannon's index and Shannon's evenness index were calculated for the 10 items of the questionnaire and for DLQI and DLQI-R total scores.Mean DLQI and DLQI-R scores of patients were 6.13 vs. 6.91. In the subset of patients with NRRs (n=261, 41%), absolute informativity was higher with the DLQI-R scoring for all eight items with NRR options in all three conditions. DLQI-R exhibited a better relative informativity in 8, 8 and 6 items in pemphigus, morphea and psoriasis, respectively. DLQI-R led to an improvement in average item-level informativity in all DLQI score bands up to 20 points. Regarding total scores, DLQI-R produced both a higher absolute and relative informativity in all three conditions.In morphea, pemphigus and psoriasis patients, the DLQI-R scoring improves the discriminatory power of the questionnaire by benefiting from the additional information in NRRs. The DLQI-R scoring may be useful both in clinical practice and research. A scoring chart has been developed to aid physicians with scoring.

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