Pictorial representation of illness and self measure (PRISM): an effective tool to assess the burden of psoriasis.
BACKGROUND
Psoriasis has a negative impact on patient's' quality of life, which may reflect the physical and psychosocial impact of the disease. However, little is known about the perceived burden of disease. Pictorial Representation of Illness and Self Measure (PRISM), a pictorial tool, was developed to measure this global suffering. Capturing quality of life impairments in psoriasis is an integral part of assessing the overall disease severity and planning effective treatment strategies.


OBJECTIVE
To validate Pictorial Representation of Illness and Self Measure (PRISM) in psoriasis patients.


METHODS
An investigator initiated, prospective cohort study was performed in 108 outpatients with psoriasis to validate PRISM as an appropriate tool; Reliability was assessed in a cohort with controlled stable disease, repeated after 1 hour and after a 3-month follow-up phase; Convergent validity determined by correlation against measures of life quality (DLQI) and reported severity of psoriasis (PASI, PGA and BSA) was performed.


RESULTS
For PRISM, we found a high reliability for short-term measurements (ICC = 0.98, P < 0.001) and for follow-up assessments at 3 months (ICC = 0.76, P < 0.001). Our investigation showed significant differences between patients with clear to minimal (PGA 0, 1), mild (PGA 2) and moderate-to-severe disease (PGA 3, 4) and significant (P < 0.001) correlation with DLQI, PGA, PASI and BSA (ρ = -0.62, -0.54, -0.44 and -0.39 respectively).


CONCLUSIONS
PRISM is a highly reliable tool and new approach to assess perceived burden of patients with psoriasis. It is easy to use and we recommend the application as an additional outcome measure in clinical trial settings.
Department of Dermatology, Venereology and Allergology, Goethe University Frankfurt, Frankfurt, Germany.
K
K
Fotiou
Department of Dermatology, Venereology and Allergology, Goethe University Frankfurt, Frankfurt, Germany.
M
M
Hofmann
Department of Dermatology, Venereology and Allergology, Goethe University Frankfurt, Frankfurt, Germany.
R
R
Kaufmann
Comprehensive Center for Inflammation Medicine, University Medical Center Schleswig-Holstein, University of Lübeck, Lübeck, Germany.
D
D
Thaci
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001296:Audiovisual Aids; D017281:Cost of Illness; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011565:Psoriasis / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D055815:Young Adult