A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale.
OBJECTIVES:We wished to validate our recently devised 16-item ENLIST ENL Severity Scale, a clinical tool for measuring the severity of the serious leprosy associated complication of erythema nodosum leprosum (ENL). We also wished to assess the responsiveness of the ENLIST ENL Severity Scale in detec...
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ftdoajarticles:oai:doaj.org/article:494c8830dec049d4aaa11c5bac5d5485 2023-05-15T15:14:52+02:00 A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale. Stephen L Walker Anna M Sales C Ruth Butlin Mahesh Shah Armi Maghanoy Saba M Lambert Joydeepa Darlong Benjamin Jewel Rozario Vivek V Pai Marivic Balagon Shimelis N Doni Deanna A Hagge José A C Nery Kapil D Neupane Suwash Baral Biliom A Sangma Digafe T Alembo Abeba M Yetaye Belaynesh A Hassan Mohammed B Shelemo Peter G Nicholls Diana N J Lockwood Erythema Nodosum Leprosum International STudy Group 2017-07-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005716 https://doaj.org/article/494c8830dec049d4aaa11c5bac5d5485 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5510881?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005716 https://doaj.org/article/494c8830dec049d4aaa11c5bac5d5485 PLoS Neglected Tropical Diseases, Vol 11, Iss 7, p e0005716 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005716 2022-12-31T06:25:16Z OBJECTIVES:We wished to validate our recently devised 16-item ENLIST ENL Severity Scale, a clinical tool for measuring the severity of the serious leprosy associated complication of erythema nodosum leprosum (ENL). We also wished to assess the responsiveness of the ENLIST ENL Severity Scale in detecting clinical change in patients with ENL. METHODS:Participants, recruited from seven centres in six leprosy endemic countries, were assessed using the ENLIST ENL Severity Scale by two researchers, one of whom categorised the severity of ENL. At a subsequent visit a further assessment using the scale was made and both participant and physician rated the change in ENL using the subjective categories of "Much better", "somewhat better", "somewhat worse" and "much worse" compared with "No change" or "about the same". RESULTS:447 participants were assessed with the ENLIST ENL Severity Scale. The Cronbach alpha of the scale and each item was calculated to determine the internal consistency of the scale. The ENLIST ENL Severity Scale had good internal consistency and this improved following removal of six items to give a Cronbach's alpha of 0.77. The cut off between mild ENL and more severe disease was 9 determined using ROC curves. The minimal important difference of the scale was determined to be 5 using both participant and physician ratings of change. CONCLUSIONS:The 10-item ENLIST ENL Severity Scale is the first valid, reliable and responsive measure of ENL severity and improves our ability to assess and compare patients and their treatments in this severe and difficult to manage complication of leprosy. The ENLIST ENL Severity Scale will assist physicians in the monitoring and treatment of patients with ENL. The ENLIST ENL Severity Scale is easy to apply and will be useful as an outcome measure in treatment studies and enable the standardisation of other clinical and laboratory ENL research. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 7 e0005716 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Stephen L Walker Anna M Sales C Ruth Butlin Mahesh Shah Armi Maghanoy Saba M Lambert Joydeepa Darlong Benjamin Jewel Rozario Vivek V Pai Marivic Balagon Shimelis N Doni Deanna A Hagge José A C Nery Kapil D Neupane Suwash Baral Biliom A Sangma Digafe T Alembo Abeba M Yetaye Belaynesh A Hassan Mohammed B Shelemo Peter G Nicholls Diana N J Lockwood Erythema Nodosum Leprosum International STudy Group A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
OBJECTIVES:We wished to validate our recently devised 16-item ENLIST ENL Severity Scale, a clinical tool for measuring the severity of the serious leprosy associated complication of erythema nodosum leprosum (ENL). We also wished to assess the responsiveness of the ENLIST ENL Severity Scale in detecting clinical change in patients with ENL. METHODS:Participants, recruited from seven centres in six leprosy endemic countries, were assessed using the ENLIST ENL Severity Scale by two researchers, one of whom categorised the severity of ENL. At a subsequent visit a further assessment using the scale was made and both participant and physician rated the change in ENL using the subjective categories of "Much better", "somewhat better", "somewhat worse" and "much worse" compared with "No change" or "about the same". RESULTS:447 participants were assessed with the ENLIST ENL Severity Scale. The Cronbach alpha of the scale and each item was calculated to determine the internal consistency of the scale. The ENLIST ENL Severity Scale had good internal consistency and this improved following removal of six items to give a Cronbach's alpha of 0.77. The cut off between mild ENL and more severe disease was 9 determined using ROC curves. The minimal important difference of the scale was determined to be 5 using both participant and physician ratings of change. CONCLUSIONS:The 10-item ENLIST ENL Severity Scale is the first valid, reliable and responsive measure of ENL severity and improves our ability to assess and compare patients and their treatments in this severe and difficult to manage complication of leprosy. The ENLIST ENL Severity Scale will assist physicians in the monitoring and treatment of patients with ENL. The ENLIST ENL Severity Scale is easy to apply and will be useful as an outcome measure in treatment studies and enable the standardisation of other clinical and laboratory ENL research. |
format |
Article in Journal/Newspaper |
author |
Stephen L Walker Anna M Sales C Ruth Butlin Mahesh Shah Armi Maghanoy Saba M Lambert Joydeepa Darlong Benjamin Jewel Rozario Vivek V Pai Marivic Balagon Shimelis N Doni Deanna A Hagge José A C Nery Kapil D Neupane Suwash Baral Biliom A Sangma Digafe T Alembo Abeba M Yetaye Belaynesh A Hassan Mohammed B Shelemo Peter G Nicholls Diana N J Lockwood Erythema Nodosum Leprosum International STudy Group |
author_facet |
Stephen L Walker Anna M Sales C Ruth Butlin Mahesh Shah Armi Maghanoy Saba M Lambert Joydeepa Darlong Benjamin Jewel Rozario Vivek V Pai Marivic Balagon Shimelis N Doni Deanna A Hagge José A C Nery Kapil D Neupane Suwash Baral Biliom A Sangma Digafe T Alembo Abeba M Yetaye Belaynesh A Hassan Mohammed B Shelemo Peter G Nicholls Diana N J Lockwood Erythema Nodosum Leprosum International STudy Group |
author_sort |
Stephen L Walker |
title |
A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale. |
title_short |
A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale. |
title_full |
A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale. |
title_fullStr |
A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale. |
title_full_unstemmed |
A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale. |
title_sort |
leprosy clinical severity scale for erythema nodosum leprosum: an international, multicentre validation study of the enlist enl severity scale. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005716 https://doaj.org/article/494c8830dec049d4aaa11c5bac5d5485 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 7, p e0005716 (2017) |
op_relation |
http://europepmc.org/articles/PMC5510881?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005716 https://doaj.org/article/494c8830dec049d4aaa11c5bac5d5485 |
op_doi |
https://doi.org/10.1371/journal.pntd.0005716 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
11 |
container_issue |
7 |
container_start_page |
e0005716 |
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1766345262855356416 |