For a study, researchers used caregiver-provided photos (p-EASI) and videos (v-EASI) to apply the Eczema Area and Severity Index (EASI) in order to measure the validity and reliability of remote atopic dermatitis (AD) severity assessment.

They sought kids (0–17 years old) who had been given an AD diagnosis by a doctor. Parents recorded a movie and took pictures of their child’s skin. A clinician-rated the in-person EASI on the same day, and p- and v-EASI scores were given to each participant 10 days or more later. The p-EASI and v-EASI were scored by two more doctors. Using in-person EASI as the gold standard, Lin’s concordance correlation coefficient (CCC) was used to evaluate the criteria validity. The p-EASI and v-inter-rater EASI’s reliability was assessed using intraclass correlation coefficients (ICCs).

With a range of AD severity (EASI: 6.3±6.4) and Fitzpatrick skin types (1-2: 9%; 3-4: 60%; 5-6: 31%), 50 racially and ethnically diverse kids (age [mean ± SD]: 4.3 ± 4.4 years; 42% female) were enrolled and given an in-person EASI evaluation. The same in-person rater and two other raters assigned 50 subjects p-EASI and 49 subjects v-EASI. The CCC and ICC for p-EASI were 0.89 95% CI [0.83, 0.95] and 0.81, 95% CI [0.71, 0.89], respectively. For v-EASI, the CCC and ICC were 0.75 (95% CI: 0.63, 0.88) and 0.69 (0.51, 0.81), respectively.

p-EASI demonstrated strong criterion validity and good inter-rater reliability in the varied sample with a range of skin tones. The criterion validity and interrater reliability of the v-EASI were moderate to good. Both may be trustworthy and legitimate choices for determining the severity of AD from a distance.