{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T07:55:47Z","timestamp":1793778947025,"version":"4.6.1"},"reference-count":491,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:00:00Z","timestamp":1679875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Division of Infection and Immunity"},{"DOI":"10.13039\/100008235","name":"School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008235","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000866","name":"Cardiff University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000866","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,16]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Over 29 years of clinical application, the Dermatology Life Quality Index (DLQI) has remained the most used patient-reported outcome (PRO) in dermatology due to its robustness, simplicity and ease of use.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To generate further evidence of the DLQI's utility in randomized controlled trials (RCTs) and to cover all diseases and interventions.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The methodology followed PRISMA guidelines and included seven bibliographical databases, searching articles published from 1 January 1994 until 16 November 2021. Articles were reviewed independently by two assessors, and an adjudicator resolved any opinion differences.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 3220 screened publications, 454 articles meeting the eligibility criteria for inclusion, describing research on 198 190 patients, were analysed. DLQI scores were primary endpoints in 24 (5.3%) of studies. Most studies were of psoriasis (54.1%), although 69 different diseases were studied. Most study drugs were systemic (85.1%), with biologics comprising 55.9% of all pharmacological interventions. Topical treatments comprised 17.0% of total pharmacological interventions. Nonpharmacological interventions, mainly laser therapy and ultraviolet radiation treatment, comprised 12.2% of the total number of interventions. The majority of studies (63.7%) were multicentric, with trials conducted in at least 42 different countries; 40.2% were conducted in multiple countries. The minimal clinically importance difference (MCID) was reported in the analysis of 15.0% of studies, but only 1.3% considered full score meaning banding of the DLQI. Forty-seven (10.4%) of the studies investigated statistical correlation of the DLQI with clinical severity assessment or other PRO\/quality of life tools; and 61\u201386% of studies had within-group scores differences greater than the MCID in \u2018active treatment arms\u2019. The Jadad risk-of-bias scale showed that bias was generally low, as 91.8% of the studies had Jadad scores of \u2265 3; only 0.4% of studies showed a high risk of bias from randomization. Thirteen per cent had a high risk of bias from blinding and 10.1% had a high risk of bias from unknown outcomes of all participants in the studies. In 18.5% of the studies the authors declared that they followed an intention-to-treat protocol; imputation for missing DLQI data was used in 34.4% of studies.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This systematic review provides a wealth of evidence of the use of the DLQI in clinical trials to inform researchers\u2019 and \u00adclinicians\u2019 decisions for its further use. Recommendations are also made for improving the reporting of data from future RCTs using the DLQI.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/bjd\/ljad079","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T06:56:20Z","timestamp":1679900180000},"page":"315-339","source":"Crossref","is-referenced-by-count":28,"title":["A systematic review of 454 randomized controlled trials using the Dermatology Life Quality Index: experience in 69\u00a0diseases and 43 countries"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2839-2651","authenticated-orcid":false,"given":"Jui","family":"Vyas","sequence":"first","affiliation":[{"name":"Centre for Medical Education"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1628-4306","authenticated-orcid":false,"given":"Jeffrey R","family":"Johns","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4184-2023","authenticated-orcid":false,"given":"Faraz M","family":"Ali","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravinder K","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5257-1142","authenticated-orcid":false,"given":"John R","family":"Ingram","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4612-5699","authenticated-orcid":false,"given":"Sam","family":"Salek","sequence":"additional","affiliation":[{"name":"School of Life and Medical Sciences, University of Hertfordshire , Hatfield , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2143-1646","authenticated-orcid":false,"given":"Andrew Y","family":"Finlay","sequence":"additional","affiliation":[{"name":"Division of Infection and Immunity, School of Medicine, Cardiff University , Cardiff , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,27]]},"reference":[{"key":"2024021708483354900_ljad079-B1","first-page":"997","article-title":"The Dermatology Life Quality Index 1994\u20132007: a comprehensive review of validation data and clinical results","volume":"159","author":"Basra","year":"2008","journal-title":"Br J Dermatol"},{"key":"2024021708483354900_ljad079-B2","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1159\/000496923","article-title":"The evolution of quality of life assessment and use in dermatology","volume":"235","author":"Chernyshov","year":"2019","journal-title":"Dermatology"},{"key":"2024021708483354900_ljad079-B3","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1046\/j.1365-2133.2003.05158.x","article-title":"Dermatology Life Quality Index: influence of an illustrated version","volume":"148","author":"Loo","year":"2003","journal-title":"Br J Dermatol"},{"key":"2024021708483354900_ljad079-B4","doi-asserted-by":"crossref","first-page":"2464","DOI":"10.1038\/jid.2012.147","article-title":"Dermatology Life Quality Index (DLQI): a paradigm shift to patient-centered outcomes","volume":"132","author":"Finlay","year":"2012","journal-title":"J\u00a0Invest Dermatol"},{"key":"2024021708483354900_ljad079-B5","author":"Finlay"},{"key":"2024021708483354900_ljad079-B6","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1111\/bjd.14788","article-title":"A systematic review of the use of quality-of-life instruments in randomized controlled trials for psoriasis","volume":"176","author":"Ali","year":"2017","journal-title":"Br J Dermatol"},{"key":"2024021708483354900_ljad079-B7","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/jdv.12106","article-title":"Psoriasis Area Severity Index (PASI) and the Dermatology Life Quality Index (DLQI): the correlation between disease severity and psychological burden in patients treated with biological therapies","volume":"28","author":"Mattei","year":"2014","journal-title":"J Eur Acad Dermatol Venereol"},{"issue":"Suppl. 2","key":"2024021708483354900_ljad079-B8","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/j.1468-3083.2009.03563.x","article-title":"What are the best outcome measures for assessing quality of life in plaque type psoriasis? 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