Skip to main content
Log in

Responsiveness of the Dermatology-specific Quality of Life (DSQL) instrument to treatment for acne vulgaris in a placebo-controlled clinical trial

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

The Dermatology-specific Quality of Life (DSQL) instrument is a new tool which has been developed to address the effects of skin disease and its treatment on physical and social functioning and self- perceptions. Previous reports have demonstrated its cross-sectional validity. The current study examines the DSQL's responsiveness to 12 weeks of acne treatment in a placebo-controlled randomized clinical trial. The DSQL change scores were moderately correlated (r=0.18 to 0.37) with treatment efficacy parameters including: dermatologist's rating of improvement of acne and a skin irritation score, and highly correlated with patient's global rating of acne severity. Within treatment groups, the DSQL discriminated clinically meaningful changes associated with small and moderate effect sizes. The DSQL total score showed statistically significant differences on nearly all comparisons with placebo. The DSQL dimension scores were sensitive to the most effective therapy compared to placebo. Responsiveness benchmarks are provided for small and moderate-sized treatment effects. As a comprehensive instrument, the DSQL is a practical and psychometrically sound tool for use in clinical trials in dermatology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Pochi PE. The pathogenesis and treatment of acne. Annu Rev Med 1990; 41: 187-198.

    Google Scholar 

  2. Motley RJ, Finlay AY. Practical use of a disability index in the routine management of acne. Clin Exp Dermat 1992; 17: 1-3.

    Google Scholar 

  3. Shuster S, Fisher GH, Harris E, Binnell D. The effect of skin disease on self image. Br J Dermatol 1978; 99: 18-9.

    Google Scholar 

  4. Medansky RS, Handler RM, Medansky DL. Self-evaluation of acne and emotion: a pilot study. Psychosomatics 1981; 22: 379-83.

    Google Scholar 

  5. Koo JY, Smith LL. Psychologic aspects of acne. Pediatric Dermatol 1985; 8: 185-188.

    Google Scholar 

  6. Finlay AY, Khan GK. The Dermatology Life Quality Index: A simple practical measure for routine clinical use. Clin Exp Dermatol. 1994, 19: 210-216.

    Google Scholar 

  7. Wu SF, Kinder BN, Trunnel TN, et al. Role of anxiety and anger in some patients: a relationship with the severity of the disorder 1988.

  8. Lowe JG. The stigma of acne. Br J Hospital Med 1993; 49: 809-812.

    Google Scholar 

  9. Motley RJ, Finlay AY. How much disability is caused by acne? Clini Exp Dermatol 1989; 14: 194-198.

    Google Scholar 

  10. Krowchuk DP, Stancin T, Keskinen R, et al. The psychosocial effects of acne on adolescents. Pediatr Dermatol 1990; 8: 332-338.

    Google Scholar 

  11. Fried RG, Shalita AR. The reciprocal interaction between acne and the psyche. Focus Cutis Psyche 1992; November; 23-33.

  12. Poorman SG. Webb CA. Sexuality and self-concept: issues in skin disease. Dermatol Nursing 1992; 4: 279-286.

    Google Scholar 

  13. Jowett S, Ryan T. Skin disease and handicap: an analysis of the impact of skin conditions. Soc Sci Med 1985; 20: 425-429.

    Google Scholar 

  14. Gupta MA, Gupta AK, Schork NJ et al. Psychiatric aspects of the treatment of mild to moderate facial acne. Int J Dermatol 1990; 29: 719-721.

    Google Scholar 

  15. McKenna KE, Stern RS. The outcomes movement and new measures of the severity of psoriasis. J Am Acad Dermatol 1996; 34(3): 534-538.

    Google Scholar 

  16. Anderson, R, Rajagopalan, R. Development and validation of a dermatology specific quality of life instrument. J Am Acad Dermatol, July, 1997; 35.

  17. Rajagopalan R Anderson RT. A profile of patients with contact dermatitis with suspected allergy (history, physical characteristics and quality of life). Am J Contact Dermat, 1997.

  18. Lennox R. Structural validation of the DSQL: confirmation of the factor structure and justification of the scoring algorithm. In: Rajagopalan R, Sherertz E Anderson RT, eds. Care Management of Skin Diseases: Life Quality and Economic Impact. New York, NY: Marcel Dekker Inc., 1997.

    Google Scholar 

  19. Hays RD, Anderson RT, Revicki D. Psychometric considerations in evaluating health-related quality of life measures. Qual Life Res 1993; 2: 441-450.

    Google Scholar 

  20. Cohen J. Statistical Power Analysis for the Behavioral Sciences. New York: Academic Press, 1977: 8.

    Google Scholar 

  21. Kazis, L.E. Anderson JJ, Meenan, RF. Effect sizes for interpreting changes in health status. Med Care, 1989; 27: S178-S189.

    Google Scholar 

  22. Guyatt G, Walter S, Norman G. Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis, 1987; 40, 171-178.

    Google Scholar 

  23. Hays R, Hadorn D. Responsiveness to change: an aspect of validity, not a separate dimension. Qual Life Res, 1992; 1: 73-75.

    Google Scholar 

  24. Chambers LW, Haight M, Norman G, MacDonald L. Sensitivity to change and the effect of model of administration on health status measurement. Med Care, 1987; 25: 470-480.

    Google Scholar 

  25. Ware JE, Snow KK, Kosinski M, Landek B. SF-36 Health Survey: Manual and Interpretation Guide. Boston, MA: Nimrod Press, 1993.

    Google Scholar 

  26. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika 1951; 16: 297-334.

    Google Scholar 

  27. Nunnally J. Psychometric Theory 2nd edn. New York: McGraw-Hill, 1978.

    Google Scholar 

  28. Crowne DP, Marlowe D. A New scale of social desirability independent of Psychopathology. J Consult Psy 1960; 4: 349-354.

    Google Scholar 

  29. Mallon E, Newton JN, Klassen A, Ryan TJ, Finlay AY. Standard patient assessed quality of life instruments can be used to measure benefits of acne treatment. Br J Dermatol, 1995; 133: 575-578.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Anderson, R., Rajagopalan, R. Responsiveness of the Dermatology-specific Quality of Life (DSQL) instrument to treatment for acne vulgaris in a placebo-controlled clinical trial. Qual Life Res 7, 723–734 (1998). https://doi.org/10.1023/A:1008832917452

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1008832917452

Navigation