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The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis
Abstract
OBJECTIVE: To test the reliability of the eczema area and severity index (EASI) scoring system by assessing inter- and intra-observer consistency. DESIGN: Training of evaluators, application, and assessment over 2 consecutive days. SETTING: An academic center. PATIENTS: Twenty adults and children with atopic dermatitis (AD); cohort 1 (10 patients > or = 8 years) and cohort 2 (10 patients < 8 years). INTERVENTIONS: None. MAIN OUTCOME MEASURE: The EASI was used by 15 dermatologist evaluators to assess atopic dermatitis in cohort 1 and cohort 2 on 2 consecutive days. Inter- and intraobserver reliability were analyzed. RESULTS: Overall intra-evaluator reliability of the EASI was in the fair-to-good range. Inter-evaluator reliability analyses indicated that the evaluators assessed the patients consistently across both study days. CONCLUSIONS: This study demonstrated that the EASI can be learned quickly and utilized reliably in the assessment of severity and extent of AD. There was consistency among the evaluators between consecutive days of evaluation. These results support the use of the EASI in clinical trials of therapeutic agents for AD.
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“Severity scoring systems are routinely used to assist clinicians with treatment decisions and to evaluate treatment efficacy in practice.8”
From Assessing the performance of artificial intelligence models in evaluating inflammatory skin disease severity: a systematic review and meta-analysis (2025) · cites this paper as [8]
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Metadata
- Authors
- Hanifin, J. M., Thurston, M., Omoto, M., Cherill, R., Tofte, S. J., Graeber, M., & Evaluator Group, T. E.
- Affiliations
- Oregon Health & Science University (US)
- Novartis (Switzerland) (CH)
- Shiga University of Medical Science (JP)
- Corresponding author
- Hanifin, J. M.
- ORCID
- Hanifin, J. M.
- Venue
- Experimental Dermatology
- Publisher
- Wiley
- Published
- 2001-02
- Volume
- 10
- Issue
- 1
- Pages
- 11-18
- ISSN
- 0906-6705 (ISSN-L)
- 1600-0625
- OpenAlex
- W2117359358
- Cited by
- 1,200
- References
- 17
- Citations by year
- 2026: 69 · 2025: 85 · 2024: 92 · 2023: 101 · 2022: 84 · 2021: 98 · 2020: 82 · 2019: 63 · 2018: 47 · 2017: 46 · 2016: 53 · 2015: 28 · 2014: 43 · 2013: 23 · 2012: 21
- FWCI
- 20.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Experimental Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
- Health Sciences › Medicine › Dermatology › Contact Dermatitis and Allergies
- Keywords
- Eczema Area and Severity Index, atopic dermatitis, inter-rater reliability, intra-rater reliability, disease severity assessment, disease extent assessment, clinical trial outcome measures
- MeSH terms
- Adolescent, Adult, Child, Child, Preschool, Dermatitis, Atopic, Dermatology, Eczema, Humans, Infant, Infant, Newborn, Severity of Illness Index, Reproducibility of Results, Cohort Studies, Observer Variation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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