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Development and validation of a severity scale for leprosy Type 1 Reactions

Development and validation of a severity scale for leprosy Type 1 Reactions
Development and validation of a severity scale for leprosy Type 1 Reactions
Objectives: To develop a valid and reliable quantitative measure of leprosy Type 1 reactions.

Methods: A scale was developed from previous scales which had not been validated. The face and content validity were assessed following consultation with recognised experts in the field. The construct validity was determined by applying the scale to patients in Bangladesh and Brazil who had been diagnosed with leprosy Type 1 reaction. An expert categorized each patient's reaction as mild or moderate or severe. Another worker applied the scale. This was done independently. In a subsequent stage of the study the agreement between two observers was assessed.

Results: The scale had good internal consistency demonstrated by a Cronbach's alpha >0.8. Removal of three items from the original scale resulted in better discrimination between disease severity categories. Cut off points for Type 1 reaction severities were determined using Receiver Operating Characteristic curves. A mild Type 1 reaction is characterized using the final scale by a score of 4 or less. A moderate reaction is a score of between 4.5 and 8.5. A severe reaction is a score of 9 or more.

Conclusions: We have developed a valid and reliable tool for quantifying leprosy Type 1 reaction severity and believe this will be a useful tool in research of this condition, in observational and intervention studies, and in the comparison of clinical and laboratory parameters.

1935-2727
e351
Walker, Stephen L.
8b78787e-d775-4057-a026-ab66179bfcd3
Nicholls, Peter G.
524cf465-2f84-41f4-9580-94abed4c3f65
Butlin, C. Ruth
9022fcaf-f1d1-4995-bd3e-dee2b9c8b5fd
Nery, Jose Augusto C.
9b827c54-557e-4694-9899-e1b7f5c7a0e6
Roy, Hemanto K.
30bbe724-c88d-4fc4-8e75-60b0147b3445
Rangel, Emanual
3cb544e0-e920-47c0-aeb7-9ed13a4d7d15
Sales, Anna M.
fd2c5690-8ab0-432e-b4ca-6ce78f78367b
Lockwood, Diana N.J.
347a15a0-9690-4128-bacd-c2030f5f4799
Walker, Stephen L.
8b78787e-d775-4057-a026-ab66179bfcd3
Nicholls, Peter G.
524cf465-2f84-41f4-9580-94abed4c3f65
Butlin, C. Ruth
9022fcaf-f1d1-4995-bd3e-dee2b9c8b5fd
Nery, Jose Augusto C.
9b827c54-557e-4694-9899-e1b7f5c7a0e6
Roy, Hemanto K.
30bbe724-c88d-4fc4-8e75-60b0147b3445
Rangel, Emanual
3cb544e0-e920-47c0-aeb7-9ed13a4d7d15
Sales, Anna M.
fd2c5690-8ab0-432e-b4ca-6ce78f78367b
Lockwood, Diana N.J.
347a15a0-9690-4128-bacd-c2030f5f4799

Walker, Stephen L., Nicholls, Peter G., Butlin, C. Ruth, Nery, Jose Augusto C., Roy, Hemanto K., Rangel, Emanual, Sales, Anna M. and Lockwood, Diana N.J. (2008) Development and validation of a severity scale for leprosy Type 1 Reactions. PLoS Neglected Tropical Diseases, 2 (12), e351. (doi:10.1371/journal.pntd.0000351). (PMID:19104651)

Record type: Article

Abstract

Objectives: To develop a valid and reliable quantitative measure of leprosy Type 1 reactions.

Methods: A scale was developed from previous scales which had not been validated. The face and content validity were assessed following consultation with recognised experts in the field. The construct validity was determined by applying the scale to patients in Bangladesh and Brazil who had been diagnosed with leprosy Type 1 reaction. An expert categorized each patient's reaction as mild or moderate or severe. Another worker applied the scale. This was done independently. In a subsequent stage of the study the agreement between two observers was assessed.

Results: The scale had good internal consistency demonstrated by a Cronbach's alpha >0.8. Removal of three items from the original scale resulted in better discrimination between disease severity categories. Cut off points for Type 1 reaction severities were determined using Receiver Operating Characteristic curves. A mild Type 1 reaction is characterized using the final scale by a score of 4 or less. A moderate reaction is a score of between 4.5 and 8.5. A severe reaction is a score of 9 or more.

Conclusions: We have developed a valid and reliable tool for quantifying leprosy Type 1 reaction severity and believe this will be a useful tool in research of this condition, in observational and intervention studies, and in the comparison of clinical and laboratory parameters.

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Published date: 23 December 2008

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Local EPrints ID: 166985
URI: https://eprints.soton.ac.uk/id/eprint/166985
ISSN: 1935-2727
PURE UUID: 08ae2623-0b2f-4ff4-8553-3a8d47c0bba4

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Date deposited: 04 Nov 2010 13:53
Last modified: 18 Nov 2019 21:01

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Contributors

Author: Stephen L. Walker
Author: Peter G. Nicholls
Author: C. Ruth Butlin
Author: Jose Augusto C. Nery
Author: Hemanto K. Roy
Author: Emanual Rangel
Author: Anna M. Sales
Author: Diana N.J. Lockwood

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