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November 2003

"Objective" Measures of Atopic Dermatitis SeverityIn Search of the Holy Grail

Author Affiliations

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Arch Dermatol. 2003;139(11):1490-1492. doi:10.1001/archderm.139.11.1490

THERE ARE now almost as many scales for measuring atopic dermatitis (AD) as there are randomized trials.1,2 Most of the 56 modified or unnamed scales in use have not been tested at all, and in many instances, the word valid when used in reports referencing a scale simply means "used before."3 The current situation is analogous to the Tower of Babel: scores of investigators over the world, each using his or her own favorite modified scale, yet unable to understand each other because they do not speak a common language. I am tempted to call for a moratorium on all new AD scales until we (clinicians, patients, and industry and drug regulators) have adequately assessed the ones that are already in existence.1 Such an exercise might help us to agree on 1 or 2 measures that could be used as standards in all future studies, just as our colleagues in rheumatology have done with the ARA20 for rheumatoid arthritis.4 Such a standard for AD would allow readers of published trials to compare results across studies.

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