CLINICAL VALIDATION AND GUIDELINES FOR THE SCORAD INDEX - CONSENSUS REPORT OF THE EUROPEAN TASK-FORCE ON ATOPIC-DERMATITIS

Background: We have previously reported how-the SCORAD index was desig ned, This cumulative index combines objective (extent and intensity of lesions) and subjective (daytime pruritus and sleep loss) criteria, A ims: To study interobserver variability in scoring for objective SCORA D criteria and to optimize the scoring guidelines, Material and Method s: Three scoring sessions were organized in 1993-1994 in Hamburg, Bord eaux and Rotterdam totalizing 19 patients (14 children and 5 adults) a nd 23 physicians, among whom 12 participated in at least 2 scoring ses sions; 169 evaluation sheets have been processed using the SCORAD File Marker Pro software. at each session, total body photographs and clos e-up views were taken of each patient, and this material was reviewed at the final evaluation, Results: The extent of lesions according to t he rule of nines showed interobserver variability mostly for patients with lesions of moderate intensity involving 20-60% of body surface, I ntensity items were scored with more consistency overall, but variatio ns subsided especially for oozing/crusts and lichenifications, Low and high scorer profiles and the benefit of training were noted, Conclusi ons: This study has allowed to optimize clinical scoring using the SCO RAD system, A proposal has been made to grade the severity of atopic d ermatitis according to objective criteria in three groups for inclusio n in clinical trials. The SCORAD index remains the major criterion for follow-up in trials.