This publication is part of the DEAL contract with Wiley.
Abstract
Acne is one of the most common skin conditions affecting all age groups, especially adolescents and young adults.1 The transition into adulthood is a crucial period of development including many changes and challenges, such as professional progress, making and strengthening relationships and forming one's personal identity.2 Having visible acne impedes these developmental tasks and, in the ...
Abstract
Acne is one of the most common skin conditions affecting all age groups, especially adolescents and young adults.1 The transition into adulthood is a crucial period of development including many changes and challenges, such as professional progress, making and strengthening relationships and forming one's personal identity.2 Having visible acne impedes these developmental tasks and, in the absence of a cure, affected people must learn to live with their skin condition. Effective treatments are therefore essential. In order to measure efficacy of different treatments, well‐developed and validated patient‐reported outcome measures should be available and capture improvements from the patient's perspective.3 Being an important outcome of acne treatments, appearance should be measured in every clinical trial. What is more important for an affected patient, especially for adolescents and young adults, than how their skin, acne and acne scars look and improve? Because appearance is in the eye of the beholder, a self‐report is needed to capture this concept. There are some acne‐specific measures available, but they often overlook this subjective concept. In this issue of the BJD, Klassen et al. dared to develop a new instrument filling this gap, the ACNE‐Q.4 Addressing the concept appearance comprehensively, this measure is novel. An important criterion to ensure good quality of the development of a measure is a patient‐oriented approach. Patients as well as different healthcare providers were involved in the whole development process. Three top‐level domains with several major and minor themes emerged. Feedback of clinical experts was obtained and cognitive interviews with affected patients were conducted to assess content validity of the scales according to the COSMIN criteria.5 Modern psychometric analyses using the Rasch Measurement Theory were performed to identify items with poor fit and different measurement properties of the ACNE‐Q, such as structural validity, internal consistency, test–retest reliability and construct validity, were assessed. The study is limited to the North American population. However, a large sample size (n = 256) recruited from two countries and different settings, i.e. hospital and community dermatology clinics, was involved in the validation study. Although the ACNE‐Q is quite long, with 73 items in seven scales, it is a comprehensive and promising measure that can be used in clinical practice and research to measure appearance and appearance‐related distress and symptoms. This study lays the ground for future studies on the validation and feasibility of the ACNE‐Q.