Development and psychometric validation of the REFlective evaLuation of psoriasis Efficacy of Treatment and Severity (REFLETS) questionnaire: a common measure of plaque-type psoriasis severity and treatment efficacy for patients and clinicians
Article first published online: 25 JUL 2014
© 2014 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of the European Academy of Dermatology and Venereology.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Journal of the European Academy of Dermatology and Venereology
Volume 29, Issue 3, pages 498–506, March 2015
How to Cite
Gilet, H., Roborel de Climens, A., Arnould, B., Bachelez, H., Bagot, M., Beaulieu, P., Joly, P., Jullien, D., Le Maître, M., Ortonne, J.P., Paul, C. and Thibout, E. (2015), Development and psychometric validation of the REFlective evaLuation of psoriasis Efficacy of Treatment and Severity (REFLETS) questionnaire: a common measure of plaque-type psoriasis severity and treatment efficacy for patients and clinicians. Journal of the European Academy of Dermatology and Venereology, 29: 498–506. doi: 10.1111/jdv.12601
- Conflicts of interest
- Conflicts of interest
- HB, MB, PB, PJ, DJ, MM, JPO and CP have served as consultants for AbbVie Laboratories and received research funding from AbbVie Laboratories. As part of the scientific advisory board, they were involved at each milestone of the development and validation process. BA, HG and ARC are employees of Mapi, which was funded by AbbVie to conduct the development and validation of the instrument, perform the statistical analysis, and interpret the results. ET is employed by AbbVie and may own AbbVie stock. AbbVie participated in the interpretation of data, review and approval of the manuscript.
- Funding sources
- Funding sources
- The design, study conduct and financial support for the study were provided by AbbVie Laboratories.
- Issue published online: 16 FEB 2015
- Article first published online: 25 JUL 2014
- Manuscript Accepted: 19 MAY 2014
- Manuscript Received: 27 FEB 2014
To date, there is no global consensus on the definition of the severity of psoriasis. The REFlective evaLuation of psoriasis Efficacy of Treatment and Severity (REFLETS) questionnaire has recently been developed to provide a better understanding of plaque-type psoriasis severity and treatment efficacy from both patient and clinician perspectives.
This study aimed to develop and psychometrically validate the new REFLETS questionnaire to evaluate patient and clinician perceptions of plaque-type psoriasis severity and treatment efficacy.
Two similar versions of the REFLETS questionnaire were developed following a rigorous methodology for clinicians and patients, referring to ‘the psoriasis of your patient' or to ‘your psoriasis’, respectively. An observational, longitudinal, multicentre study was conducted in France with 34 dermatologists and 430 mild to severe plaque-type psoriasis patients to finalize the questionnaire and evaluate its psychometric properties.
Two dimensions were defined – severity and treatment efficacy – with three subdimensions within severity (impact of psoriasis, symptoms and disease course), and two individual items on joint pain. The questionnaire was well accepted by clinicians and patients. Excellent internal consistency (Cronbach's alpha = 0.66–0.98) and test–retest reliability (intraclass correlation coefficients = 0.83–0.94) were demonstrated. REFLETS scores were moderately to highly correlated to Psoriasis Area and Severity Index (r = 0.35–0.70), Skindex-29 (r = 0.46–0.82) and DLQI scores (r = 0.36–0.82). Patients with decreased psoriasis severity and those with increased treatment efficacy, according to patient global evaluations, had lower severity and higher treatment efficacy REFLETS scores, respectively.
REFlective evaLuation of psoriasis Efficacy of Treatment and Severity is a promising tool for assessing plaque-type psoriasis severity and treatment efficacy from patient and clinician perspectives. It may help to improve patient and clinician communication in treatment decision making.