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<p>Validated scoring systems in use for assessing severity of pemphigus are not validated for use in tele-dermatology. The objective of the study was to assess level of agreement between disease severity scores determined during teleconsultation and in-person visits. A hospital-based cross-sectional study was conducted with 80 pemphigus patients. Each patient underwent both tele and in-person consultation within five days of each other. Photographs were captured and scored using PDAI, ABSIS, ODSS, and POLIS by three independent dermatologists. Test-retest reliability was assessed using intraclass correlation coefficients (ICC), and agreement was further examined through Bland–Altman analysis. Inter-rater reliability and convergent validity of the scoring tools were also evaluated. The total ABSIS (ICC = 0.945) and PDAI (ICC = 0.929) demonstrated excellent and good test-retest reliability, respectively. Among mucosal-only scores, POLIS showed the highest reliability (ICC = 0.977), followed by ODSS and mucosal ABSIS. Bland–Altman analysis confirmed acceptable agreement margins for most scores, with POLIS and ABSIS showing the smallest bias and narrowest limits of agreement. Inter-rater reliability was good to excellent across all tools. Strong convergent validity was observed between tele-consult scores. Pemphigus severity assessments via patient-submitted photographs during teleconsultation strongly correlate with in-person scores. ABSIS and POLIS, due to their higher reliability, may be better suited for remote evaluation.</p> Graphical abstract <p></p>

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Determining the reliability of existing pemphigus severity scores for tele-dermatology

  • 期刊论文

  • 发表日期：

    2026年2月28日

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  • Thammannagowda Prarthana,
  • Sanjeev Handa,
  • Sonu Goel,
  • Rahul Mahajan,
  • Vinod Hanumanthu,
  • Hitaishi Mehta,
  • Dipankar De

摘要

Validated scoring systems in use for assessing severity of pemphigus are not validated for use in tele-dermatology. The objective of the study was to assess level of agreement between disease severity scores determined during teleconsultation and in-person visits. A hospital-based cross-sectional study was conducted with 80 pemphigus patients. Each patient underwent both tele and in-person consultation within five days of each other. Photographs were captured and scored using PDAI, ABSIS, ODSS, and POLIS by three independent dermatologists. Test-retest reliability was assessed using intraclass correlation coefficients (ICC), and agreement was further examined through Bland–Altman analysis. Inter-rater reliability and convergent validity of the scoring tools were also evaluated. The total ABSIS (ICC = 0.945) and PDAI (ICC = 0.929) demonstrated excellent and good test-retest reliability, respectively. Among mucosal-only scores, POLIS showed the highest reliability (ICC = 0.977), followed by ODSS and mucosal ABSIS. Bland–Altman analysis confirmed acceptable agreement margins for most scores, with POLIS and ABSIS showing the smallest bias and narrowest limits of agreement. Inter-rater reliability was good to excellent across all tools. Strong convergent validity was observed between tele-consult scores. Pemphigus severity assessments via patient-submitted photographs during teleconsultation strongly correlate with in-person scores. ABSIS and POLIS, due to their higher reliability, may be better suited for remote evaluation.

Graphical abstract