Identifying the Impacts of Acne: A Delphi Survey of Patients and Clinicians.

BACKGROUND: Acne can adversely impact those affected in multiple dimensions. The purpose of this study was to determine the most prominent impacts identified by acne patients and by clinicians. METHODS: Independent Delphi surveys for acne patients and clinicians were conducted to achieve consensus regarding acne impacts within each group. Acne patients were recruited from outpatient clinics of authors (AL, JT, and DT). The first phase involved qualitative responses, where emergent themes were identified and used to generate items for 2 subsequent phases. RESULTS: The qualitative phase generated 64 items in 3 themes: psychological, sociological, and treatment related. These items were independently ranked in importance by patients and by clinicians. Consensus for importance was achieved for 34 items by patients and 43 by clinicians. Patient-identified highest ranked items were being self-conscious, feeling unattractive, feeling uncomfortable in own skin, unattractive to others, would not want pictures taken, envious of people with clear skin, and time/effort spent concealing scarring; while clinicians identified feeling unattractive. CONCLUSIONS: We identify acne impacts within psychological, sociological, and treatment-related domains by acne patients and clinicians. Further, we establish discrepancies between patients and clinicians regarding the impact of acne. This provides evidence for the importance of establishing patient-reported outcomes.

Development of a Comprehensive Quality-of-Life Measure for Facial and Torso Acne.

Background Acne is a chronic skin disorder which generally presents in adolescence but continues into adulthood, and negatively affects both physical and psychosocial well-being. Presently, there are no validated acne-specific quality-of-life (QoL) measures that include dimensions for both facial and torso acne. OBJECTIVE: The objective of this study was to develop a QoL instrument for both facial and torso acne (CompAQ) in accordance with recommended standards. METHODS: A literature review and Delphi survey of patients and clinicians were used to develop the conceptual framework for outcomes perceived important to acne patients. An initial version of the measure was developed, CompAQ-v1, and pilot tested with patients via cognitive interviews. RESULTS: The Delphi survey generated 4 domains (physical, psychological, sociological, and treatment) and 54 items. These, along with a literature review and input from clinical experts, informed the development of the CompAQ-v1. Eleven cognitive interviews were conducted, resulting in the second version of the measure, CompAQ-v2. Psychometric validation resulted in the final 20-item CompAQ measure comprising 5 domains. An abbreviated 5-item measure was also developed (CompAQ-SF). CONCLUSION: CompAQ and CompAQ-SF are instruments intended to evaluate QoL in patients with acne on their face or torso. The former is a 21-item QoL intended for research, while the latter is intended for clinical practice.

I deserve more A's: A report on the development of a measure of academic entitlement.

This paper reports the results of a multi-stage effort to develop a measure of Academic Entitlement. An empirical/rational approach was taken to develop items and reduce the item set for a final version of the Academic Entitlement Scale (AES). The measure includes seven dimensions: Accommodation, Reward for Effort, Responsibility Avoidance, Grade Haggling, Customer Orientation, Customer Service Expectations, and General Academic Entitlement. Fit, using Confirmatory Factor Analysis, for the seven-factor correlated model and a bifactor model including General AE and the six specific factors, was good. The full measure is reported along with descriptive statistics for the scale and preliminary validation evidence.

The Relationship Between Dermatologist- and Patient-Reported Acne Severity Measures and Treatment Recommendations.

BACKGROUND: Acne treatment recommendations for individual patients may be derived from multiple factors including dermatologist- and patient-reported constructs. OBJECTIVES: To evaluate the effects of dermatologist- and patient-reported measures on acne treatment recommendations by dermatologists. METHODS: An observational cross-sectional survey of acne patients was conducted with patient-reported quality of life and dermatologist-reported measures of primary and secondary (scar) acne severity using 3 assessment approaches: maximal regional grade, total grade, and facial grade. RESULTS: The most highly associated factors with acne treatment recommendations were patient emotions, maximal regional acne severity, and total acne scar grade. Better acne-specific quality of life was negatively related to acne treatment recommendation intensity, while all 3 grading approaches were positively related to acne treatment recommendations. CONCLUSIONS: For dermatologists, overall acne severity is most highly associated with maximal regional acne grade, total scar grade, and patient's emotional response to acne.