title: Naildex: pilot evaluation of an onychodystrophy severity instrument.
abstract: A valid and reliable measure that captures onychodystrophy disease severity is important for both clinical and research applications. Three hundred and twenty-two patients at two Veterans Affairs Medical Centers with clinical evidence of onychodystrophy suggesting onychomycosis (at least 25% in a distal subungual pattern) were examined using Naildex parameters. Naildex scores were calculated by a combination of: per cent of each nail infected, area of each nail and number of infected nails. Patients also completed a nail-specific quality of life questionnaire (NailQoL) and nail samples were collected and examined mycologically. Data was analysed for all enrolled patients (n = 322) and patients with mycologically-confirmed onychomycosis (n = 243). Inter-rater reliability was calculated from two examiners who each evaluated 17 patients with mycologically-confirmed onychomycosis. Significant correlations (P < 0.01) between Naildex and NailQoL as well as proxy measures (duration of infection) indicated construct validity of the instrument for all patients as well as mycologically-confirmed cases. Strong correlation (r = 0.754, P < 0.01, n = 17) indicated high inter-rate reliability. This pilot evaluation suggests that Naildex is a valid and reliable measure of onychomycosis severity.
authors: Department of Dermatology, University of Minnesota, Minneapolis, MN 55417, USA. erin.warshaw@med.va.gov
authors: Erin M
authors: EM
authors: Warshaw
authors: Carmen A
authors: CA
authors: Traywick
authors: Allison A
authors: AA
authors: Hoffman
authors: Kia K
authors: KK
authors: Lilly
authors: Rebecca L
authors: RL
authors: Koshnick
authors: Janet W
authors: JW
authors: Robinson
authors: Pitiporn
authors: P
authors: Suwattee
authors: Jovonne K
authors: JK
authors: Foster
authors: Suephy C
authors: SC
authors: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003883:Arthrodermataceae / Q000302:isolation & purification; D019719:Diagnostic Equipment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000382:microbiology / Q000473:pathology; D014009:Onychomycosis / Q000175:diagnosis* / Q000523:psychology; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires