Naildex: pilot evaluation of an onychodystrophy severity instrument.
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.
Warshaw
Erin M
EM
Department of Dermatology, University of Minnesota, Minneapolis, MN 55417, USA. erin.warshaw@med.va.gov
Traywick
Carmen A
CA
Hoffman
Allison A
AA
Lilly
Kia K
KK
Koshnick
Rebecca L
RL
Robinson
Janet W
JW
Suwattee
Pitiporn
P
Foster
Jovonne K
JK
Chen
Suephy C
SC
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