Reliability and agreement testing of a new automated measurement method to determine facial vitiligo extent using standardized ultraviolet images and a dedicated algorithm.

Autor:	Marin Dit Bertoud Q; Newtone Technologies, Research and Development, Lyon, France., Bertold C; Université Côte d'Azur, CHU Nice, Department of Dermatology, Nice, France., Ezzedine K; Department of Dermatology, AP-HP, Henri Mondor University Hospital, Créteil, France.; Université Paris Est (UPEC), EpiDermE Research Unit, Paris, France., Pandya AG; Palo Alto Foundation Medical Group, Sunnyvale, CA, USA.; Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA., Cherel M; Newtone Technologies, Research and Development, Lyon, France., Castillo Martinez A; Newtone Technologies, Research and Development, Lyon, France., Seguy MA; Newtone Technologies, Research and Development, Lyon, France., Abdallah M; Department of Dermatology, Andrology and Venereology, Ain Shams University, Cairo, Egypt., Bae JM; Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea., Böhm M; Department of Dermatology, University of Münster, Münster, Germany., Parsad D; Department of Dermatology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India., Rosmarin D; Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA., Wolkerstorfer A; Department of Dermatology, Netherlands Institute for Pigment Disorders, Amsterdam University Medical Centers, Amsterdam, the Netherlands., Bahadoran P; Université Côte d'Azur, CHU Nice, Department of Dermatology, Nice, France., Blaise M; Université Côte d'Azur, CHU Nice, Department of Dermatology, Nice, France., Dugourd PM; Université Côte d'Azur, CHU Nice, Department of Dermatology, Nice, France., Philippo V; Université Côte d'Azur, CHU Nice, Department of Dermatology, Nice, France., Delaval JM; Newtone Technologies, Research and Development, Lyon, France., Passeron T; Université Côte d'Azur, CHU Nice, Department of Dermatology, Nice, France.; Université Côte d'Azur, INSERM, U1065, C3M, Nice, France.
Jazyk:	angličtina
Zdroj:	The British journal of dermatology [Br J Dermatol] 2023 Dec 20; Vol. 190 (1), pp. 62-69.
DOI:	10.1093/bjd/ljad304
Abstrakt:	Background: Facial repigmentation is the primary outcome measure for most vitiligo trials. The Facial Vitiligo Area Scoring Index (F-VASI) score is often chosen as the primary outcome measure to assess the efficacy of treatments for facial vitiligo. Although useful, this scoring system remains subjective and has several limitations. Objectives: To assess the agreement and reliability of an algorithmic method to measure the percentage depigmentation of vitiligo on the face. Methods: We developed a dedicated algorithm called Vitil-IA® to assess depigmentation on standardized facial ultraviolet (UV) pictures. We then conducted a cross-sectional study using the framework of the ERASE trial (NCT04843059) in 22 consecutive patients attending a tertiary care centre for vitiligo. Depigmentation was analysed before any treatment and, for 7 of them, after 3 and 6 months of narrowband UVB treatment combined with 16 mg methylprednisolone, both used twice weekly. Interoperator and interacquisition repeatability measures were assessed for the algorithm. The results of the algorithmic measurement were then compared with the F-VASI and the percentage of depigmented skin scores assessed by 13 raters, including 7 experts in the grading of vitiligo lesions. Results: Thirty-one sets of pictures were analysed with the algorithmic method. Internal validation showed excellent reproducibility, with a variation of < 3%. The percentage of depigmentation assessed by the system showed high agreement with the percentage of depigmentation assessed by raters [mean error (ME) -11.94 and mean absolute error (MAE) 12.71 for the nonexpert group; ME 0.43 and MAE 5.57 for the expert group]. The intraclass correlation coefficient (ICC) for F-VASI was 0.45 [95% confidence interval (CI) 0.29-0.62] and 0.52 (95% CI 0.37-0.68) for nonexperts and experts, respectively. When the results were analysed separately for homogeneous and heterogeneous depigmentation, the ICC for homogeneous depigmentation was 0.47 (95% CI 0.31-0.77) and 0.85 (95% CI 0.72-0.94) for nonexperts and experts, respectively. When grading heterogeneous depigmentation, the ICC was 0.19 (95% CI 0.05-0.43) and 0.38 (95% CI 0.20-0.62) for nonexperts and experts, respectively. Conclusions: We demonstrated that the Vitil-IA algorithm provides a reliable assessment of facial involvement in vitiligo. The study underlines the limitations of the F-VASI score when performed by nonexperts for homogeneous vitiligo depigmentation, and in all raters when depigmentation is heterogeneous. Competing Interests: Conflicts of interest Q.M.D.B., M.C., A.C.M. and M.-A.S. are employees of Newtone; J.-M.D. is the founder of Newtone. K.E. is a consultant for AbbVie, Incyte, La Roche-Posay, Pfizer, Pierre Fabre, Sanofi and Viela Bio. A.G.P. has served as an investigator for Immune Tolerance Network, Incyte and Pfizer; is a consultant for AbbVie, Arcutis, Avita Medical, Immune Tolerance Network, Incyte, Pfizer, Trifecta, TWi, Viela Bio, Vyne and Villaris; and holds stock options for Tara Medical and Zerigo Health. J.M.B. has acted as a consultant for Pfizer, AbbVie, LaserOptek, Illoco, Cutech Korea and Ilooda. D.R. has received honoraria as a consultant for AbbVie, Abcuro, AltruBio, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Concert, Dermavant Sciences, Dermira, Incyte, Janssen, Kyowa Kirin, Lilly, Novartis, Pfizer, Regeneron Pharmaceuticals, Revolo Biotherapeutics, Sanofi, Sun Pharmaceuticals, UCB and Viela Bio; has received research support from AbbVie, Amgen, Bristol Myers Squibb, Celgene, Dermira, Galderma, Incyte, Janssen, Lilly, Merck, Novartis, Pfizer and Regeneron Pharmaceuticals; and has served as a paid speaker for AbbVie, Amgen, Celgene, Janssen, Lilly, Novartis, Pfizer, Regeneron Pharmaceuticals and Sanofi. A.W. has received research grants from AVITA Medical, Lumenis and Merz; is a consultant for AVITA Medical, Lumenis, Novartis, Almirall, Janssen, AbbVie and InCyte; and has received equipment from Humeca and PerfAction. M. Böhm is a consultant for Incyte, Pfizer, AbbVie, Jansen and LEO Pharma; and has received honoraria from Incyte, Isispharma, Pfizer, AbbVie, Jansen and LEO Pharma. P.B. has received grants or honoraria from LEO Pharma, Pierre Fabre, BMS and Eli Lilly. P.-M.D. has received grants or honoraria from Almirall, Eli Lilly, Sanofi and UCB. T.P. has received grants and/or honoraria from AbbVie, ACM Pharma, Amgen, Almirall, Boehringer Ingelheim, Bristol-Myers Squibb, Calypso, Celgene, Galderma, Genzyme/Sanofi, GlaxoSmithKline, Incyte, Janssen, LEO Pharma, Eli Lilly, Novartis, Pfizer, Roivant, Sun Pharmaceuticals, UCB and Vyne therapeutics; is the co-founder of YUKIN Therapeutics; and has patent rights on the use of CXCR3B, WNT agonists and GSK3b in the treatment of vitiligo. C.B., M.A., D.P., M. Blaise and V.P. declare no conflicts of interest. (© The Author(s) 2023. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. 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