Precision and reproducibility of automated computer-guided psoriasis area and severity Index measurements in comparison with trained physicians
Background The Psoriasis Area and Severity Index (PASI) represents the gold standard for psoriasis severity assessments but is limited by its subjectivity and low intra- and inter-rater consistency. Objectives To investigate the precision and reproducibility of automated, computer-guided PASI measur...
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| Main Authors: | , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2019
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| In: |
British journal of dermatology
Year: 2019, Volume: 180, Issue: 2, Pages: 390-396 |
| ISSN: | 1365-2133 |
| DOI: | 10.1111/bjd.17200 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1111/bjd.17200 Verlag: https://onlinelibrary.wiley.com/doi/abs/10.1111/bjd.17200 
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| Author Notes: | C. Fink, C. Alt, L. Uhlmann, C. Klose, A. Enk and H.A. Haenssle |
| Summary: | Background The Psoriasis Area and Severity Index (PASI) represents the gold standard for psoriasis severity assessments but is limited by its subjectivity and low intra- and inter-rater consistency. Objectives To investigate the precision and reproducibility of automated, computer-guided PASI measurements (ACPMs) in comparison with three trained physicians. Methods This was a comparative observational study assessing ACPMs attained by automated total-body imaging and computerized digital image analysis in a cohort of 120 patients affected by plaque psoriasis of various severities. The level of agreement between ACPMs and physicians’ PASI measurements was calculated by the intraclass correlation coefficient (ICC). The reproducibility of ACPMs in comparison with physicians’ PASI measurements was investigated by performing two successive ‘repeat PASI calculations’ in the same patients. Results The agreement between ACPMs and physicians’ PASI calculations in 120 fully evaluable patients was high (ICC 0·86, 95% confidence interval 0·80-0·90, mean absolute difference 2·5 PASI points). Repeat ACPMs to measure the reproducibility showed an excellent ICC of 0·99 (95% confidence interval 0·98-0·99) with a mean absolute difference of 0·5 PASI points. The ACPMs thus outperformed the three physicians for intrarater reliability (mean ICC 0·86). Conclusions The results of this first clinical study investigating ACPMs in 120 patients with psoriasis indicate a similar precision and higher reproducibility in comparison with trained physicians. Limitations arise from poorly observable body sites and from patients unable to attain predefined postures during automated image acquisition. |
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| Item Description: | First published: 15 September 2018 Gesehen am 31.10.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1365-2133 |
| DOI: | 10.1111/bjd.17200 |