Study |

Standardizing Training for Psoriasis Measures:  Effectiveness of an Online Training Video on Psoriasis Area and Severity Index Assessment by Physician and Patient Raters

April W. Armstrong, MD, MPH; Kory Parsi, DO; Clayton W. Schupp, PhD; Philip J. Mease, MD; Kristina C. Duffin, MD
JAMA Dermatol. 2013;149(5):577-582. doi:10.1001/jamadermatol.2013.1083.
Text Size: A A A
Published online

Importance Because the Psoriasis Area and Severity Index (PASI) is the most commonly used and validated disease severity measure for clinical trials, it is imperative to standardize training to ensure reliability in PASI scoring for accurate assessment of disease severity.

Objective To evaluate whether an online PASI training video improves scoring accuracy among patients with psoriasis and physicians on first exposure to PASI.

Design This equivalency study compared PASI assessment performed by patients and PASI-naive physicians with that of PASI-experienced physicians at baseline and after standardized video training. The study was conducted from March 15, 2011, to September 1, 2011.

Setting Outpatient psoriasis clinic at University of California, Davis.

Participants Forty-two psoriasis patients and 14 PASI-naive physicians participated in the study. The scores from 12 dermatologists experienced in PASI evaluation were used as the criterion standard against which other scores were compared.

Main Outcome Measures Aggregate and component PASI scores from image sets corresponding to mild, moderate, and severe psoriasis.

Results After viewing the training video, PASI-naive physicians produced equivalent scores for all components of PASI; patients provided equivalent scores for most PASI components, with the exception of area scores for moderate-to-severe psoriasis images. After the online video training, the PASI-naive physicians and patients exhibited improved accuracy in assigning total PASI scores for mild (Meanexperienced physician − MeanPASI-naive physician: 1.2; Meanexperienced physician − Meanpatient: −2.1), moderate (Meanexperienced physician − MeanPASI-naive physician:0; Meanexperienced physician − Meanpatient: −5.7), and severe (Meanexperienced physician − MeanPASI-naive physician: −5.1; Meanexperienced physician − Meanpatient: −10.4) psoriasis, respectively.

Conclusions and Relevance Use of an online PASI training video represents an effective tool in improving accuracy in PASI scoring by both health care professionals and patients. The video-based online platform for disseminating standardized training on the use of validated instruments in dermatology represents a novel form of standardized education.

Figures in this Article



Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours


Place holder to copy figure label and caption
Graphic Jump Location

Figure 1. Study procedures. PASI indicates Psoriasis Area and Severity Index.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 2. Psoriasis Area and Severity Index (PASI) mean (SE) score changes before and after online video training.




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 1

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles
Treatment of recalcitrant erythrodermic psoriasis with ustekinumab. Eur J Dermatol Published online Apr 11, 2014.;
A Review of CT-P13: An Infliximab Biosimilar. BioDrugs Published online Apr 11, 2014.;