Creation and pilot test results of the dermatology-specific proxy instrument: the Infants and Toddlers Dermatology Quality of Life.

BACKGROUND: Until now, there was no validated dermatology-specific health-related quality of life (HRQoL) instrument to be used in youngest patients. OBJECTIVE: To create dermatology-specific proxy instrument for HRQoL assessment in children from birth to 4 years. METHODS: International focus groups, item selection and pilot tests were utilized. In order to avoid the problem of cross-cultural inequivalence, focus group work and pilot tests were planned simultaneously in all national centres of the project. Comprehensibility, clarity, acceptance and internal consistency of new instrument were checked. RESULTS: The title 'Infants and Toddlers Dermatology Quality of Life' was chosen for our new instrument with the proposed acronym 'InToDermQoL'. Focus group work was completed in seven national centres (Croatia, Germany, Greece, Malta, Poland, Romania and Ukraine). A total of 170 families of children with different skin diseases were interviewed, and a pilot version of the instrument was created. Centres from France, Denmark and Spain have joined the project at this stage. Parents of 125 children with skin diseases filled in the pilot versions of the instrument. Good comprehensibility, clarity, acceptance and internal consistency of the InToDermQoL were confirmed. The pilot test results showed that the InToDermQoL questionnaire well differentiates severity-dependent differences. It was also checked and confirmed during the pilot test that no significant information was missed in the questionnaire. Three age-specific versions of the InToDermQoL questionnaire with 10, 12 and 15 items, respectively, were approved for field tests. CONCLUSION: The pilot test results showed that the InToDermQoL questionnaire has good comprehensibility, clarity, acceptance and internal consistency and well differentiates severity-dependent differences. Further validation of the InToDermQoL during international field test will be performed.

[An end to office hours for warts? A randomized study of the effectiveness of liquid nitrogen and of the Histofreezer]. / Het einde van het wrattenspreekuur? Een gerandomiseerd onderzoek naar de effectiviteit van vloeibare stikstof en van de Histofreezer.

OBJECTIVE: Comparison of the effectiveness of liquid nitrogen and of cryotherapy by means of the Histofreezer in the treatment of hand warts. DESIGN: Randomized therapeutic trial. SETTING: Six general practices in Limburg, The Netherlands. PATIENTS AND METHODS: Of the patients 43 (with 83 warts) were treated with nitrogen (if necessary twice) and 50 (with 108 warts) with the Histofreezer (if necessary 4 times), with a final control visit after 2.5 months. After a training session, the general practitioners performed the treatments and the observations. In these groups, 7 patients (with 18 warts) and 10 patients (with 20 warts) respectively did not fully comply with the protocol. At the start the number of warts per patient, their size, protruberance and localization were registered. Statistical analysis was performed by chi 2 test (unpaired case) in an intention to treat approach and of compliers only. OUTCOME MEASURES: Disappearance of warts, pain (on a 3-point scale), wounds, depigmentation. Non-compliers were asked by telephone if their warts had been cured. RESULTS: Of all patients 58% was cured by liquid nitrogen and 28% by Histofreezer (p = 0.01). Among the compliers these percentages were 67% and 35% of the patients (p = 0.01) and 66% and 49% of the warts (p = 0.08). The treatments were about equally effective in dorsal non protuberant and small (less than 5 mm) warts, and among young (less than 20 years) patients. CONCLUSION: The overall results of liquid nitrogen were better. The Histofreezer seems to be attractive in certain cases (e.g. children), but this should be the subject of further study.