Outcome measures in chronic urticaria: A comprehensive review

Chronic urticaria, characterised by pruritic wheals, angioedema or both significantly impacts individuals' quality of life. This review article examines the patient-reported outcome measures (PROMs) in chronic urticaria assessment, aiming to enhance understanding and management of this condition The review categorises PROMs into urticaria-specific and angioedema-specific tools. Urticaria-specific PROMs such as the Urticaria Activity Score (UAS), Urticaria Control Test (UCT), Chronic Urticaria Quality of Life Questionnaire (CU-QoL) and Urticaria Severity Score (USS) focus on disease activity, control, severity and quality of life. Angioedema-specific tools include the Angioedema Activity Score (AAS), Angioedema Control Test (AECT) and Angioedema Quality of Life Questionnaire (AE-QoL), assessing disease activity, control and quality of life specific to angioedema. Non-specific PROMs like the Dermatology Life Quality Index (DLQI) provide a broader assessment of health-related quality of life across dermatological conditions. Newer developments include disease-specific PROMs like the Cold Urticaria Activity Score (ColdUAS), CholU-QoL for chronic inducible urticarias and the Urticaria Activity and Impact Measure (U-AIM) for retrospective patient-reported outcome assessment. Additionally, the review discusses the integration of smartphone applications and artificial intelligence (AI) tools like Convolutional Neural Networks (CNNs) in automating PROMs, showing promise in improving chronic urticaria management. Despite the progress made in PROMs, ongoing challenges such as limited data on specific populations and languages underscore the need for continued research and standardised PROM usage across clinical settings. This approach can significantly enhance patient management and contribute to a more holistic and effective strategy for addressing chronic urticaria.