Nail Assessment in Psoriasis and Psoriatic Arthritis (NAPPA): development and validation of a tool for assessment of nail psoriasis outcomes

M Augustin, C Blome, A Costanzo, E Dauden, C Ferrandiz, G Girolomoni, R Gniadecki, L Iversen, A Menter, K Michaelis-Wittern, A Morita, H Nakagawa, K Reich

50 Citationer (Scopus)

Abstract

BACKGROUND: Existing tools for nail psoriasis are complex and may not adequately measure outcomes that are important to patients.

OBJECTIVES: We have developed and validated a new tool, the Nail Assessment in Psoriasis and Psoriatic Arthritis (NAPPA), with three components: a questionnaire assessing quality of life (NAPPA-QoL), a two-part questionnaire assessing patient-relevant treatment benefits (the Patient Benefit Index, NAPPA-PBI) and a psoriasis Clinical Assessment of Severity (NAPPA-CLIN).

METHODS: Development of the questionnaires involved multiple steps: (i) collection of items about nail psoriasis-related impairments and treatment goals; (ii) selection of 48 items by an expert panel, including patients; (iii) translation into eight languages; (iv) feasibility testing and (v) longitudinal validation in six countries.

RESULTS: Patients found the questionnaires clear (84%) and comprehensible (95%). NAPPA-QoL and NAPPA-PBI scores correlated moderately with clinical outcomes [e.g. Nail Psoriasis Severity Index (NAPSI)] and markedly with other quality-of-life questionnaires (e.g. EQ-5D™). Both questionnaires were sensitive to change. Internal consistency was good (Cronbach α ≥ 0.88 for all scales). The NAPPA-CLIN, a brief version of NAPSI that involves assessment of only four digits rather than all 20, was found to correlate highly with total NAPSI score (r = 0.97, P < 0.001).

CONCLUSIONS: Overall, the three-component NAPPA tool is a valid, reliable and practical instrument to assess patient-relevant nail psoriasis outcomes.

OriginalsprogEngelsk
TidsskriftBritish Journal of Dermatology
Vol/bind170
Udgave nummer3
Sider (fra-til)591-8
Antal sider8
ISSN0007-0963
DOI
StatusUdgivet - mar. 2014

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