FS03.1 The hand eczema severity index (HECSI). A study of inter‐ and intraobserver reliability

In clinical studies on hand eczema (HE) an objective and accurate assessment of the severity of the disease is needed. The present study was undertaken in order to develop and validate a scoring system called the hand eczema severity index (HECSI) designed for clinical assessment of HE. Twelve dermatologists (observers) assessed 15 HE patients (11 women and 4 men) twice with an interval of 30 min. To minimise recall bias only the hands and wrists of the patients were visible to the observers. Agreement between the observers was determined by using the intraclass correlation coefficient (ICC). ICC for total HECSI score was 0.79 at time 1 and 0.85 at time 2 respectively. When looking at ICC for the different items in the scoring system (extent of lesions, anatomical location and intensity of clinical signs) best agreement was found for extension followed by anatomical location and least agreement was found for the scoring of clinical signs. ICC for intraobserver agreement was 0.90. A regression correlation coefficient of 0.993 was found (simple linear regression analysis of time 1 scores against time 2 scores) indicating high reproducibility. Overall good agreement existed for both inter- and intraobserver reliability although some inter- and intraobserver variation existed.