EASI for clinical signs
The Eczema Area and Severity Index (EASI) is a validated scoring system that grades the physical signs of atopicdermatitis/eczema. EASI is the core outcome for measuring the clinical signs of eczema in all trials. For details of how this consensus was reached please click here.
EASI is freely available for use and resources below are freely available to download. You do not need a license to use EASI, but we are interested to know how it is being used, so we would appreciate it if you could email us if you are planning to use EASI.
EASI user guide - a simple written guide
EASI training video - a detailed, 17 minute video.
EASI Scoring table for under 8's EASI Scoring table for aged 8 and over
EASI calculator - download onto a PC or Mac for calculating EASI scores. If you experience difficulties downloading via Internet Explorer try another browser such as Google Chrome.
EASI calculator App - for calculating EASI scores on i-devices (iPhone, iPod, iPad) and *NEW* for Android devices.
Special thanks to Lawrence Brown who developed the EASI calculator apps and the version for PC and Mac with design input from Sara Brown.
Interpreting EASI scores:
Publication on interpretability of the EASI score and how it relates to mild, moderate and severe disease: Lesham YA, Hajar T, Hanifin JM, Simpson EL. What the EASI score tells us about the severity of atopic dermatitis - an interpretability study. Br J Dermatol 2015 Jan 12. doi: 10.1111/bjd.13662
Publication on inter-rater reliability of clinician rated signs instruments in skin of colour: Zhao CY, Hao EY, Oh DD, Daniel BS, Martin LK, Su JC, Rodrigues M, Murrell DF. A comparison study of clinician-rated atopic dermatitis outcome measures for intermediate to dark skin patients. Br J Dermatol 2016 Dec 23. doi:10.1111\bjd.15271
Here are some training materials that you can use for your training sessions on using EASI:
- Overview slides about how to use EASI
- Test images for your investigators to score the intensity of eczema as they would when using EASI using the test slides scoring sheet
- Test images including answers to use for checking with your investigators.
These are freely available to use, but please do email us to let us know you are using them.
Frequently asked questions
Can I alter the wording/adapt EASI?
We do not advise making any changes to the wording of EASI as this is likely to change its validity. Alterations to the layout/presentation (e.g. addition of trial logos or for use on a tablet / phone) is permitted.
Are there any translations of EASI available?
We are not aware of any translations available, but if you do translate EASI, we recommend you follow this guidance:
1. The text should be translated by 2 or more people who are:a. Fluent in both the language EASI is being translated into and English b. Familiar with the locality where the outcome measure will be used
2. The questionnaires should be translated back into English by an independent translator. The back translated version should be approved as being appropriate by a native English speaker with dermatology experience.
The translation doesn’t need to be exact translation of the wording but the meaning should be retained. The translated version must have the same structure and logic as the original.
I work for/on behalf of an organisation which requires EASI to be translated into another language. What permissions are needed?
You do not need a license to translate EASI into another language. We are however keen to make translated versions of the scale available to others in the eczema research community, so we would appreciate it if those who create translations would send us a copy to us, and allow us to share it on this webpage (we will of course acknowledge your contribution).Note: We appreciate that some translation companies require permissions to be confirmed by email, so please do get in touch if this is the case.
POEM for patient-reported symptoms
The Patient Oriented Eczema Measure (POEM) is a validated instrument completed by patients or carers that measures the illness experienced by the patient. POEM is the core outcome for measuring the patient-reported symptoms in all eczema trials. For details of how this consensus was reached please click here.
Click here for the POEM scale and guidance on using POEM including translations. This material is all freely available.
Roadmap for developing Core Outcome Sets (COS)
The HOME group have published a methodological framework to use when developing and implementing a Core Outcome Set (COS).
The paper covers the entire process, starting with defining the scope and setting of the core set, determining the core domains to be measured such as symptoms or quality of life, the identification or development and validation of appropriate outcome measurement instruments to measure these core domains and finally dissemination and implementation.
Schmitt J, Apfelbacher C, Spuls PI, Thomas KS, Simpson EL, Furue M, Chalmers J, Williams HC. The Harmonising Outcomes for Eczema (HOME) roadmap: A methodological framework to develop core sets of outcome measurements in dermatology. J Invest Dermatol 2015 Jan;135(1):24-30. doi: 10.1038/jid.2014.320. Epub 2014 Sep 4
Professor Hywel Williams discusses the HOME roadmap with Dr. Robert Dellavalle. Listen to the podcast here.
COS-STAR developing core outcome sets
Core outcome sets can increase the effiency and value of research and, as a result, there are an increasing number of studies looking to develop core outcomes sets (COS). However, the credibility of a core outcome set depends on both the use of sound methodology in its development and clear and transparent reporting of the processes adopted. To date there is no reporting guideline for reporting core outcome sets studies.
The aim of this programme of research is to develop a reporting guideline for studies developing core outcome sets and to highlight some of the important methodological considerations in the process.
Kirkham JJ, et al on behalf of the COS-STAR Group. COS-STAR: a reporting guideline for studies developing core outcome sets (protocol). Trials 2015 Aug 22;16:373. doi: 10.1186/s13063-015-0913-9.
Plain Language Summaries
The COMET group have produced freely available plain language summaries on Core Outcome Sets and on Delphi exercises.
Please feel free to use the slides below. If you require a powerpoint version, please contact us at HOME@nottingham.ac.uk :