Self-reported versus physician-reported severity of hand eczema - Concordance analysis based on data from the German CARPE registry

Background and Objective: Self-assessment of general health status includes a variety of verifiable objective and subjective criteria and shows a significant influence on patient-related outcomes such as quality of life. The objective of this study was to investigate how patients assess the severity of their chronic hand eczema compared to physicians.Patients and method: Data for 1281 patients and their physicians from the German registry “CARPE” was available at baseline. At a 2-year follow-up, the remaining 788 cases served as a comparison. Concordance analysis was performed using Bangdiwala's B.Results:Only 16.62% (baseline) and 11.47% (follow-up) of the severity ratings showed complete concordance. The baseline shows a more pessimistic, the follow-up a more optimistic assessment from the patients compared to the physicians. Women and older patients had lower agreement. Bangdiwala's B value lies at the lower border of a substantial agreement ( B̂ω(baseline)=0.573, B̂ω(follow-up)=0.498).Conclusion:The assessment of the severity of hand eczema often differs between physician and patient. To ensure successful therapy and adherence, dermatologists should inquire about their patients' individual perception of the severity of the hand eczema, especially in older patients and women.