The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis


Jon M. Hanifin, Professor of Dermatology, Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Road, Portland, OR 97201–3098, USA
Tel.: 503 494 5603. Fax: 503 494 6907


Abstract:Objective– To test the reliability of the eczema area and severity index (EASI) scoring system by assessing inter- and intra-observer consistency. Design: Training of evaluators, application, and assessment over 2 consecutive days. Setting– An academic center. Patients– Twenty adults and children with atopic dermatitis (AD); cohort 1 (10 patients ≥8 years) and cohort 2 (10 patients <8 years). Interventions– None. Main outcome measure– The EASI was used by 15 dermatologist evaluators to assess atopic dermatitis in cohort 1 and cohort 2 on 2 consecutive days. Inter- and intraobserver reliability were analyzed. Results– Overall intra-evaluator reliability of the EASI was in the fair-to-good range. Inter-evaluator reliability analyses indicated that the evaluators assessed the patients consistently across both study days. Conclusions– This study demonstrated that the EASI can be learned quickly and utilized reliably in the assessment of severity and extent of AD. There was consistency among the evaluators between consecutive days of evaluation. These results support the use of the EASI in clinical trials of therapeutic agents for AD.