Measurement of actinic keratoses

Enumeration of actinic keratoses is highly variable but it is important to standardise this process as new therapies are emerging for the condition

The authors of this study set out to assess the reliability of four different methods used to quantify actinic keratoses (AKs) and to investigate whether a consensus meeting affected their reliability.

The study consisted of a single-blinded study of 12 experienced dermatologist raters counting AKs on the face and ears of nine subjects before and after a consensus meeting.

The intraclass correlation coefficient (ICC) among raters for preand post-consensus evaluations was the primary outcome measure in the study.

They reported that of the four assessment methods, the 'total count' method had the greatest ICC for both pre(0.18, P=0.04) and post-consensus (0.66, P equal to or less than 0.0001) assessments.

Total count was also the only pre-consensus evaluation for which the null hypothesis of no association among assessments was rejected.

The authors conclude that total AK count appears to be the most reliable measure of quantifying AKs on the face and ears, and that educational consensus discussion before the assessment improves the reliability of this measure.

Chen SC, Hill ND, Veledar E et al. Br J Dermatol 2013; 169: 1219-22

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