Funding sources No external funding.
Clinical and Laboratory Investigations
Reliability of quantification measures of actinic keratosis
Version of Record online: 2 DEC 2013
© 2013 British Association of Dermatologists
British Journal of Dermatology
Volume 169, Issue 6, pages 1219–1222, December 2013
How to Cite
Chen, S.C., Hill, N.D., Veledar, E., Swetter, S.M. and Weinstock, M.A. (2013), Reliability of quantification measures of actinic keratosis. British Journal of Dermatology, 169: 1219–1222. doi: 10.1111/bjd.12591
Conflicts of interest None declared.
- Issue online: 2 DEC 2013
- Version of Record online: 2 DEC 2013
- Accepted manuscript online: 19 AUG 2013 10:25AM EST
- Manuscript Accepted: 12 AUG 2013
Enumerating actinic keratoses (AKs) is highly variable but important to standardize as new therapies are emerging.
To assess the reliability of four different methods used to quantify AKs and to investigate whether a consensus meeting affects the reliability.
This was a single-blinded study of 12 experienced dermatologist raters counting AKs on the face and ears of nine subjects before and after a consensus meeting. Raters were recruited from investigators of a multicentre Veterans Affairs cooperative study. The intraclass correlation coefficient (ICC) among raters for pre- and post-consensus evaluations was the primary outcome measure.
Of the four assessment methods, the ‘total count’ method had the greatest ICC for both pre- (0·18, P = 0·04) and post-consensus (0·66, P = < 0·0001) assessments. Total count was also the only pre-consensus ICC for which the null hypothesis of no association among assessments was rejected.
Total AK count appears to be the most reliable measure of quantifying AKs on the face and ears. Educational consensus discussion prior to assessment improves reliability of this measure.