title: A simple tool with which to study the course of chronic hand eczema in clinical practice: a reduced-item score.
abstract: BACKGROUND
  Physicians need a simple, disease-specific tool with which to assess disease severity and the effect of therapeutic intervention in patients with chronic hand eczema. The currently available clinical scoring systems include numerous items, which makes them laborious to complete and limit their use in daily practice.
  
  
  OBJECTIVE
  To develop a simple tool with which to assess disease severity of patients with chronic hand eczema.
  
  
  METHODS
  We evaluated two tools, the Hand Eczema Severity Index (HECSI) and the Hand Eczema Area and Severity score, to determine their ability to predict the Investigator's Global Assessment (IGA) of disease severity in patients with moderate to severe hand eczema. We used a stepwise reduction analysis to determine a minimal set of significantly contributing items for predicting IGA.
  
  
  RESULTS
  A three-item score, based on the highest observed value of induration, fissuring, and scaling, predicted IGA with a correlation of 0.667. The HECSI predicted the IGA with a correlation of 0.675.
  
  
  CONCLUSIONS
  On the basis of this analysis, we propose a simple tool for clinical decision-making and evaluation of therapeutic intervention in daily practice.
authors.affiliation: Department of Dermatology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands. P.vanderValk@derma.umcn.nl
authors.forename: Pieter G M
authors.initials: PG
authors.lastname: van der Valk
authors.forename: Robin F
authors.initials: RF
authors.lastname: van Gils
authors.forename: Cécile R L
authors.initials: CR
authors.lastname: Boot
authors.forename: Andrea W M
authors.initials: AW
authors.lastname: Evers
authors.forename: Rogier
authors.initials: R
authors.lastname: Donders
authors.forename: Hans A C
authors.initials: HA
authors.lastname: Alkemade
authors.forename: Pieter Jan
authors.initials: PJ
authors.lastname: Coenraads
authors.forename: Thomas
authors.initials: T
authors.lastname: Rustemeyer
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Anema
mesh_terms: D002908:Chronic Disease; D015331:Cohort Studies; D018450:Disease Progression; D006229:Hand Dermatoses / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D012720:Severity of Illness Index
keywords: chronic hand eczema; clinical severity; reduced item score