{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:17:29Z","timestamp":1789053449252,"version":"build-2803163510"},"reference-count":19,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2020,6,26]],"date-time":"2020-06-26T00:00:00Z","timestamp":1593129600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010654","name":"Universidad San Francisco de Quito","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010654","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sistemas M\u00e9dicos","award":["11186"],"award-info":[{"award-number":["11186"]}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    Acne-induced scarring is associated with a similar burden as acne, i.e. diminished quality of life, and may be avoided if patients receive appropriate and timely acne treatment. In 2017, a four item-Acne-Scar Risk Assessment Tool (4-ASRAT) was designed by Tan\n                    <ns4:italic>et al<\/ns4:italic>\n                    . to categorise patients with acne into lower-risk or higher-risk for acne scarring. Its applicability outside the initial study population (France, Brazil and United States) remains to be determined.\u00a0\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods:<\/ns4:bold>\n                    A study protocol was developed to create a systematic approach for validating and adapting 4-ASRAT to different populations, Ecuador in this case. The protocol was reviewed by 11 local and international dermatologists and pilot-tested in an Ecuadorian population using a sample of 10 participants who currently had or had had acne. Feedback from the pilot study was used to improve the study protocol. The results of the pilot study are included here, and the final study protocol is available as extended data.\u00a0\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results:<\/ns4:bold>\n                    The protocol proved to be applicable. Images taken of participants were a valuable resource for dermatological evaluation about the presence or absence of acne scars. Tangential light is necessary for this evaluation. Although dermatological assessments varied, we concluded that assessment by three local dermatologists for each participant was adequate for reaching a consensus on the presence or absence of acne scars. \u00a0\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusions:<\/ns4:bold>\n                    Considering the morbidity related to acne and acne scars, tools designed as prevention that alert patients about risk of developing scarring are necessary. The proposed protocol shows a feasible way of validating and adapting 4-ASRAT to different populations.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.23737.1","type":"journal-article","created":{"date-parts":[[2020,6,26]],"date-time":"2020-06-26T08:11:22Z","timestamp":1593159082000},"page":"651","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Pilot study for the evaluation and adaptation of a Four Item-Acne-Scar Risk Assessment Tool (4-ASRAT): a resource to estimate the risk of acne-induced scars"],"prefix":"10.12688","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9773-661X","authenticated-orcid":false,"given":"Jorge","family":"Estrella Porter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikaela","family":"Camacho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Isabel","family":"Viteri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Aguilar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drifa","family":"Belhadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Bettoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita del Roc\u00edo","family":"Buest\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Dr\u00e9no","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Endara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Layton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelly","family":"Machado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Mateus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6979-5655","authenticated-orcid":false,"given":"Enrique","family":"Ter\u00e1n","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Y\u00e9pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Guillemot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2020,6,26]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"3-12","DOI":"10.1111\/bjd.13462","article-title":"A global perspective on the epidemiology of acne.","volume":"172","author":"J Tan","year":"2015","journal-title":"Br J Dermatol."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"118-126","DOI":"10.1503\/cmaj.140665","article-title":"Management of acne: Canadian clinical practice guideline.","volume":"188","author":"Y Asai","year":"2016","journal-title":"CMAJ."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"515-520","DOI":"10.4103\/0019-5154.190102","article-title":"The Psychosocial Impact of Acne Vulgaris.","volume":"61","author":"N Hazarika","year":"2016","journal-title":"Indian J Dermatol."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"46-50","DOI":"10.1111\/jdv.12053","article-title":"Which factors influence quality of life in acne patients?","volume":"28","author":"S Zauli","year":"2014","journal-title":"J Eur Acad Dermatol Venereol."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"293-300","DOI":"10.1016\/j.det.2011.11.001","article-title":"Quality of Life Measures for Acne Patients.","volume":"30","author":"L Barnes","year":"2012","journal-title":"Dermatol Clin."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"862-869","DOI":"10.1590\/s0365-05962012000600007","article-title":"The impact of acne vulgaris on quality of life and psychic health in young adolescents in Greece. Results of a population survey.","volume":"87","author":"E Tasoula","year":"2012","journal-title":"An Bras Dermatol."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"672-676","DOI":"10.1046\/j.1365-2133.1999.02768.x","article-title":"The quality of life in acne: a comparison with general medical conditions using generic questionnaires.","volume":"140","author":"E Mallon","year":"1999","journal-title":"Br J Dermatol."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"207-218","DOI":"10.1007\/s13555-016-0113-x","article-title":"How People with Facial Acne Scars are Perceived in Society: an Online Survey.","volume":"6","author":"B Dr\u00e9no","year":"2016","journal-title":"Dermatol Ther (Heidelb)."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"153-158","DOI":"10.4103\/0974-2077.167272","article-title":"The Impact of Post-Acne Scars on the Quality of Life Among Young Adults in Singapore.","volume":"8","author":"S Chuah","year":"2015","journal-title":"J 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Dermatol."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/9-651\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/9-651\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/9-651\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T11:31:32Z","timestamp":1597750292000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/9-651\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,26]]},"references-count":19,"URL":"https:\/\/doi.org\/10.12688\/f1000research.23737.1","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.26191.r65623","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.26191.r68895","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.26191.r65623","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.26191.r68895","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,26]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/9-651\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.26191.r65623, Vicente Torres Lozada, Maria Fernanda Torres-Calder\u00f3n, Dermatology Department, Hospital Juarez, Mexico City, Mexico, 03 Aug 2020, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/9-651\/v1#referee-response-65623","order":0,"name":"referee-response-65623","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Jorge Estrella<\/b>; \n<i>Posted: 17 Aug 2020<\/i>; Dear Dr. Vicente Torres ad Dr. Mar&iacute;a Fernanda Torres-Calder&oacute;n:As the lead author, we welcome with great joy your peer review. Like you, we believe that 4-ASRAT is a simple tool, easy to use and to understand, but with great potential for use as a primary prevention tool, which will allow the early identification of those patients at high risk of developing acne scars. Although the original questionnaire has more than 20 questions, the next phase of the study will allow us to determine which of these questions have greater relevance and weight as predictors of the risk of acne scars, with which we will be able to develop a questionnaire with fewer questions to be applied to the patients. We believe that its use in primary care, including by general practitioners, will allow the timely referral of patients with acne and high risk of scars, to dermatologists, so patients will be able to receive prompt and specialized care.","URL":"https:\/\/f1000research.com\/articles\/9-651\/v1#referee-comment-5823","order":1,"name":"referee-comment-5823","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.26191.r68895, Zhou Bing-Rong, Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China, 17 Aug 2020, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/9-651\/v1#referee-response-68895","order":2,"name":"referee-response-68895","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Jorge Estrella<\/b>; \n<i>Posted: 17 Aug 2020<\/i>; Dear Dr&nbsp;Zhou Bing-Rong:As the lead author, we welcome with great pleasure your peer review. We definitely recognize that the management of acne scars still represents a challenge in dermatological clinical practice, so preventing the development of these scars should be a priority. According to our bibliographic research, one of the best ways to prevent the formation of acne scars is the timely identification of those patients with the greatest risk of developing them, so that they can receive timely and adequate treatment of their underlying disease. This is the importance of developing a tool like 4-ASRAT.The questions posed for 4-ASRAT are based on the identified risk factors for the development of acne scars. Because not all factors have the same relative risk, not all questions will be used in the final tool. A next study phase is being developed to identify which factors within those proposed are the ones that weigh the most and which consequently should be included in the final tool.Additionally, we believe that although 4-ASRAT should be used by dermatologists, it has a potential use also in primary medical care, where many patients with acne are treated but their risk of developing acne scars is not identified for their prompt referral to the service of dermatology.Finally, we do agree that defining acne scars is difficult and sometimes subjective. For subsequent studies with 4-ASRAT, we will clarify the definitions of acne scars to guarantee greater homogeneity among dermatologists in the evaluation of the same patient with acne.","URL":"https:\/\/f1000research.com\/articles\/9-651\/v1#referee-comment-5824","order":3,"name":"referee-comment-5824","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This project received research funding from Escuela de Medicina, Universidad San Francisco de Quito and SIME (Sistemas M\u00e9dicos) (Project HUBi ID: 11186). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}