John Barbieri, MD, MBA

Credit: X.com (Twitter)

The DermSat-7 questionnaire tool may be efficacious in measurement of treatment satisfaction in individuals with acne, according to recent findings.¹

These findings resulted from new research into a questionnaire designed for patients with acne, conducted given that satisfaction with treatment has been pointed to as 1 of the Acne Core Outcomes Research Network’s domains due to its relationship with adherence and outcomes.²

The research was authored by John S. Barbieri, MD, MBA, an assistant professor at Harvard Medical School. The study was conducted to assess the DermSat-7 questionnaire on treatment satisfaction of acne patients seen in clinical practice settings, with the investigators looking at the internal consistency, the structural validity, and the construct validity.

“The DermSat-7 is a dermatology-specific, 7-item questionnaire used to assess patient satisfaction with treatment,” Barbieri and colleagues wrote. “The goal of this study was to assess the structural validity, internal consistency, and construct validity of the DermSat-7 in patients with acne.”

Background and Findings

The investigators recruited English-speaking adult patients with acne, aged 18 and older, and these individuals were drawn from an outpatient clinic found at Brigham and Women’s Hospital in Boston. The team’s work commenced following subjects’ review of an online fact sheet elucidating the research study, with the group completing the questionnaire between July 2022 - May 2023.

Study participants utilized an iPad in each of their clinic drop-ins to autonomously fill out their Patient-Reported Outcome Measures (PROM) questionnaires, and these were hosted on Research Electronic Data Capture (REDCap). The questionnaire used by the investigators was also accompanied by the DermSat-7 assessment tool, made up of 7 total questions that were designed to look at 3 domains of treatment: convenience (with 3 items), effectiveness (with 3 items), and overall patient satisfaction (with 1 item).

The subjects were told by the research team to look back upon the past week and to rate each DermSat-7 item on a 5-point scale. This scale held that 1 meant ‘not satisfied’ and 5 meant
‘completely satisfied’.

The investigators altered the total score for each of the included domains to a linear 0 - 100 scale, with higher scores being considered greater satisfaction. Furthermore, the subjects then used a Patient Global Assessment (PGA) of their own acne severity levels, with categories being clear, almost clear, mild, moderate, or severe.

Over the course of participants’ follow-up interactions, they were queried about shifts in the severity of their acne through the use of an anchor item, with questions similar to "How has your acne evolved since your previous visit?" These questions were evaluated using a 7-point scale with a range from –3 (much worse) to 3 (much better).

Concurrently, at each of these visits, a dermatologist implemented the Comprehensive Acne Severity Scale (CASS) for the team’s research. The primary evaluation criteria used by the team covered structural validity, internal consistency (evaluated via Cronbach α), and construct validity (appraised through the use of linear regression models and Pearson correlation coefficients).

The research ended up involving a total of 142 patients with acne using medication, and 67.6% being female. The investigators’ factor analyses was shown to have confirmed the DermSat-7's 3 domains' unidimensionality.

The notably high Cronbach α values of 0.89 and 0.80 were determined by the research team to have shown a strong internal consistency with regard to the efficacy and the convenience domains, respectively. They were able to observe known-groups validity through a substantial association between DermSat-7 score results and positive changes in subjects’ severity of disease (linear regression coefficient, 7.51; 95% CI, 4.94-10.08; P < .001).

The construct validity domain was further supported by the team’s results owing to the moderate correlations observed with PGA, anchor, and CASS score results in both effectiveness and in overall satisfaction domains (effectiveness: PGA r = –0.538, anchor r = 0.567,and CASS r = –0.485; overall satisfaction: anchor r = 0.467, PGA r = –0.486, and CASS r = –0.489).

“Future research is needed to examine additional measurement properties of the DermSat-7, such as content validity and interpretability, as well as to validate the DermSat-7 in other populations of patients with acne,” they wrote.

References

1. ^{Shields A, Armstrong AW, Kaur MN, et al. Evaluation of DermSat-7 for Assessing Treatment Satisfaction in Patients with Acne. JAMA Dermatol. Published online November 22, 2023. doi:10.1001/jamadermatol.2023.4481.}
2. ^{Layton AM, Eady EA,Thiboutot DM,TanJ; Acne Core Outcomes Research Network (ACORN) Outcomes Identification Group. Identifying what to measure in acne clinical trials: first steps towards development of a core outcome set. J Invest Dermatol. 2017;137(8):1784-1786. doi:10.1016/j.jid. 2017.04.017.}