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Reliability of skin-type self-assessment: agreement of adolescents’ repeated Fitzpatrick skin phototype classification ratings during a cohort study

Authors


  • Funding sources
    The research was conducted at the University of Newcastle.

  • Conflict of interest
    The authors do not have any conflicts of interest or potential conflicts of interest.

P. Magin. E-mail:parker.magin@necastle.edu.au

Abstract

Background  The Fitzpatrick Skin Phototype Classification (FSPC) is the most commonly used measure of skin type. In questionnaire-based surveys, self-rated FSPC is often used as a measure of respondents’ skin type.

Objective  The objective of this analysis was to assess test-retest reliability of the self-rated FSPC within a 12-month cohort study that examined the psychological sequelae of acne.

Methods  Participants were students aged 14–17 years in four Australian secondary schools; two-government system schools and two private schools. The primary outcomes were a number of psychological measures. The FSPC was assessed by a single concise questionnaire item. Test-retest agreement (as measured by quadratic weighted kappa) of participants’ self-rated FSPC at three time-points (baseline, 6 and 12 months) was calculated.

Results  Of the 244 participating students, 209 students (86%) completed all three rounds of data collection. A further 26 students (11%) completed two rounds. Quadratic weighted kappa for Rounds 1 and 2 was 0.757 (95% CI 0.663–0.831). For Rounds 2 and 3 it was 0.805 (95% CI 0.659–0.893). Between Rounds 1 and 3 it was 0.767 (95% CI 0.698–0.832). This represents good-to-very-good agreement.

Skin type was retained as an independent variable in 8 of the16 regression models built to explain psychological outcomes in this study.

Conclusion  Skin type appears to be a significant factor in psychological morbidity in acne. The FSPC is a reliable method for assessing skin phenotype, even when elicited via a concise questionnaire item suitable for assessing skin type as a potential confounder in studies of other outcome factors.

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