Self-reported Versus Physician-reported Severity of Chronic Hand Eczema: Concordance Analysis Based on Data from the German Chronic Hand Eczema Patient Long-Term Management Registry

Self-assessment of general health status has a significant influence on patient-related outcomes. The aims of this study were to investigate and compare the level of agreement between patients’ and dermatologists’ assessments of the severity of chronic hand eczema. From the German registry “German Chronic Hand Eczema Patient Long-Term Management Registry” (CARPE), 1,281 pairs of patients with chronic hand eczema and their dermatologists were included. Of these, 788 pairs served as a comparison 2 years after baseline. Concordance analyses found that complete concordance between patients’ and dermatologists’ assessments were 16.62% at baseline and 11.47% at follow-up. Overall, patients assessed their chronic eczema at baseline as more severe than did the dermatologists; whereas, at follow-up, patients assessed their condition as less severe than the dermatologists’ assessment. Bangdiwala’s B showed lower values of concordance for womens’ and older patients’ self-assessment with the dermatologists’ assessments. In conclusion, dermatologists should consider the patient’s perspective and the individual’s assessment of their chronic hand eczema in order to provide effective care in clinical practice. SIGNIFICANCE Daily clinical practice shows that, for chronic hand eczema, self-reported and physician-reported severity may differ and may influence treatment success. This study found low levels of agreement between dermatologists’ and patients’ assessments of the severity of the condition. Statistical analysis showed that women and older people tended to assess the severity of their condition differently compared with the dermatologist’s perspective. At follow-up patients assessed their chronic hand eczema as less severe compared with their dermatologist. To ensure better treatment success, dermatologists should take into account the personal views of patients regarding their chronic hand eczema.