OBJECTIVES: To establish the domain structure and scoring, and evaluate the psychometric properties of the Alopecia Areata Patient Priority Outcomes (AAPPO) questionnaire in adults and adolescents with Alopecia Areata (AA).
METHODS: Measurement properties of the AAPPO were examined using data from a prospective, noninterventional, web-based study of 121 AA patients (36 adolescents ages 12-17 years and 85 adults ages ≥18 years) with ≥25% hair loss, who completed two assessments (baseline and follow up 2 weeks later). Analyses provided here are inclusive of all patients (n=121).
RESULTS: Exploratory and confirmatory factor analysis supported 6 domains: 4 individual Hair Loss (HL) items, Emotional Symptoms (ES, 4 items) and Activity Limitations (AL, 3 items). The multi-item ES and AL domains had strong internal consistency (Cronbach's alpha≥0.87). All domain scores had strong test-retest reliability (ICC≥0.78). The four HL domain scores demonstrated strong construct validity (r≥0.52) when compared to the patient-reported Alopeica Areata Symptom and Impact Scale hair loss scale score. The ES and AL domain scores exhibited strong construct validity (Irl≥0.66) when compared to the patient-reported SF-36 Mental Component Summary score. Known groups analyses revealed that the HL mean domain scores were better (lower) in the clinican-reported Severity of ALopecia Tool (SALT) 25%-49% subgroup compared to those with the highest SALT scores (76%-100%; p<0.0001). However, the ES mean domain scores were better for the SALT 76%-100 group in the same comparison (p<0.0001).
CONCLUSIONS: These data demonstrate the reliability and validity of the AAPPO to measure symptom severity and impacts in adults and adolescents with AA.
