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Reliability of the Vitiligo Area Scoring Index measurement tool for vitiligo
Aunna Pourang1, Indermeet Kohli1,2, Nneamaka Ezekwe1,3
1Photomedicine and Photobiology Unit, Department of Dermatology, Henry Ford Health, Detroit, Michigan.
Background:
A reliable instrument is needed to assess vitiligo severity and treatment response.
Objective:
To assess inter- and intrarater variability and accuracy of the Vitiligo Area Scoring Index among trained raters and to evaluate a proposed Vitiligo Area Scoring Index using equidistant 10% depigmentation increments (VASI 10%).
Methods:
In this prospective study, 12 raters evaluated images of 10 participants with vitiligo on 2 occasions using total body Vitiligo Area Scoring Index (T-VASI) and facial Vitiligo Area Scoring Index (F-VASI) scores after training. Inter- and intrarater reliabilities and accuracy vs digital scores were determined using intraclass correlation coefficients. VASI 10% scores were evaluated separately for interrater reliability and accuracy.
Results:
F-VASI interrater reliability improved from "moderate" to "good" between time points, while T-VASI was "good" at both time points. Intrarater reliability ranged from "good" to "excellent" for T-VASI and "poor" to "excellent" for F-VASI. Accuracy intraclass correlation coefficient was "good" to "excellent" for most raters. Interrater reliability using VASI 10% was "moderate" for both T-VASI and F-VASI.
Limitations:
Small participant population and number of raters; participants were not assessed in person; no repeated VASI 10% measures.
Conclusion:
Vitiligo Area Scoring Index generally provides good to excellent reliability for assessment of vitiligo by raters who receive standardized training.
