The development of a practical and reliable assessment measure for atopic dermatitis (ADAM)

Previous measures of Atopic Dermatitis (AD) have not been adequate for research purposes. This paper describes a study conducted in dermatology clinics of the Royal Children's Hospital, Melbourne, Australia, to develop a reliable, valid and practical measure. A pool of items to describe both site and morphology of AD was generated from a literature survey and expert opinion. Selected items were incorporated into a measure with each item rated on a four point scale. The measure was piloted and revised to a simpler format and called the Atopic Dermatitis Assessment Measure (ADAM). Unidimensionality was established. Reliability was determined by comparing two doctors blind ratings on 51 patients (mean age = 70 months). Agreement varied depending upon site and morphology with more agreement on "mild" AD than on "severe" AD. These results imply that operational definitions of the scales need to be defined more clearly. The measure satisfies the assumptions for a partial credit analysis.