AUAS7

AUAS7: the best weapon in the dermatologyst arsenal against urticaria

Table of Contents

    Introduction

    The future of dermatology is now within hands reach thanks to Legit.Health‘s revolutionary AUAS7 (Automatic Urticaria Activity Score). The researchers have developed a tool that processes smartphone images and automatically analyses them using the same criteria as the UAS7.

    Is widely known that objective, reliable, and precise outcome measures are key to the practice of evidence-based medicine. The UAS7 has proven to have the best measurement properties and is the most recommended for use in clinical trials when considering urticaria.

    Estimating is guessing, counting is measuring

    Alfonso Medela, CAIO

    UAS7 the fundation of the diagnois of urticaria

    Due to the variable nature of urticaria, which can happen as a chronic disease (with daily rashes that vary in intensity and extension) to momentary developments of the symptoms, the most used scoring system for this affection is the UAS7.

    The Urticaria Activity Score (UAS) was developed as a simple scoring system that takes into account the number of wheels and the intensity of the itching they produce. Despite these variables being recorded by the patients, many considered that their affection could not be accurately described by the isolated analysis of their state in one day.

    Thus the UAS7 was born, an aggregate of all the UAS scores of a patient over seven days that allows the doctor to better understand the full extension of the disease.

    The main shortcoming of UAS7

    Despite the many urticaria variants where it does not apply, the UAS7 is still considered the gold standard for the assessment of the severity of chronic urticaria.

    The UAS7 records, over 7 consecutive days, the daily number of wheals and the intensity of itch. It is the guideline-recommended gold standard for measuring disease activity in CSU…

    Marcus Maurera et all, Urticaria: Collegium Internationale Allergologicum (CIA) Update 2020. Int Arch Allergy Immunol. DOI: 10.1159/000507218

    This system’s main weakness, like many other PROMs( Patient Reported Outcome Meassures), is its reliance on the patient to recollect the data. A patient that not only lacks the medical expertise of a doctor but is suffering from a debilitating and stressful condition that might push them into exaggerating their symptoms to try and get better attention.

    Consistency is another main issue. Is a known fact that many patients will forget to fill in their UAS for the day, leading to incomplete data. But this has nothing to do with the inherent clinical properties of UAS7, and that’s why it was chosen as the base for Legit.Health‘s revolutionary AUAS7.

    Speed up the pathology reporting process and improve the patient’s quality of life.

    How do we know what scoring system is better?

    Among the many criteria for rating the quality of outcome measures, some stand out as key to determining whether a scoring system is useful:

    • timer1. Ease of useCan be applied easily, given constraints of time and money
    • gradient2. Sensitivity to changeAbility to detect clinically important changes over time
    • theater_comedy3. Interobserver reliabilityDifferent investigators provide identical results
    • thumbs_up_down4. Intra-observer variabilityRepeated measurement by the same investigator provide identical results
    • speed5. InterpretabilityAssigns qualitative meaning to scores (mild, severe…)

    Methods and definitions to rate the quality of outcome measures. Schmitt, J., Langan, S., Deckert, S., Svensson, A., von Kobyletzki, L., Thomas, K., & Spuls, P. (2013). Assessment of clinical signs of atopic dermatitis: A systematic review and recommendation. Journal of Allergy and Clinical Immunology, 132(6), 1337–1347. doi:10.1016/j.jaci.2013.07.008

    Why AUAS7 is the best tool to determine the severity of cronic urticaria

    Legit.Health is the revolutionary Clinical Data and Communication tool for Next-generation dermatologists that triples the empowerment of patients.

    In cases like chronic urticaria, where the data recollection is in the hands of the patients, having the best tool to ensure that the recorded information is objective, accurate and reliable is of the utmost importance. This becomes especially true in clinical trials, where the precision of the data can make the difference between a successful study and a muddy one.

    Legit.Health‘s algorithms automatically grade lesions just by looking at smartphone images and reduce the small patient-reported outcome measures (PROMs) to the bare minimum, using them only to record variables like itchiness that cannot be seen on a photograph. In other words: the tool will automatically fill in most of the dermatology scoring systems, such as PASISCORAD, IHS4GAGS, and of course, UAS.

    The main goal of AUAS7 is to provide a tool to record data precisely and consistently for routine evaluations and clinical studies.

    1. Is easy to use

    Ease of use is paramount in our modern society, but especially in a case like the severity assessment of chronic urticaria.

    Thanks to the revolutionary deep learning algorithm developed by Legit.Health and the design of its interface, the patients won’t need to count the number of wheals, nor have to remember to take the measurement, as a notification in their smartphone will remind them to take a simple picture.

    This picture is analyzed by the clinically validated algorithm and its results are sent to the doctor, which benefits not only from the consistency of the data generated by this process but makes much easier the job of monitoring rashes and the development of the disease.

    After all, communication between the doctor and the patient is one of the cornerstones of medicine, and it should be easy.

    2. Is more precise and reliable

    Legit.Health‘s tool analyzes the pathologies using a validated scoring system that has both the lowest MID (Minimal important Difference) and is sensible to the lowest LDC (Lowest Detectable Change), which means the algorithm analyzes every image with more precision and attention to detail than any human observer would.

    In clinical trials, quantification of the disease is critical to measure the efficacy of an investigational treatment by comparing the severity of disease before therapy to that measured after treatment.

    Richard G. Langley, MD,a and Charles N. Ellis, MDb Halifax, Nova Scotia, and Ann Arbor, Michigan Evaluating psoriasis with Psoriasis Area and Severity Index, Psoriasis Global Assessment, and Lattice System Physician’s Global Assessment

    Furthermore, it has a higher validity and reliability while maintaining comparable clinimetric properties, thanks to the intrinsic functioning of computer vision algorithms. 

    3. Eliminates the intrinsic variability of a PROM

    Due to the algorithmic nature of AUAS7, the intra-observer variability is eliminated completely and without doubt, as every image and calculation is neatly stored in the app’s database.

    After all, when calculating the traditional UAS, doctors are relying on the ability of the patient to count the wheals. These patients, who have no medical training, are under pressure to give their doctor critical information to develop their treatment, increasing their stress and adding even more inconvenience to their daily lives.

    This kind of measuring approach leads to a lot of variability that, with the right tool, is easy to avoid.

    4. Allows the patient to report rashes in real-time

    Thanks to the tool developed by Legit.Health, a patient no longer needs to wait for a doctor appointment to report on a flare-up of their affection.

    The app allows the patient to take a simple picture with their smartphone, and send it to an algorithm that will automatically count the number of wheals. Afterward, the app runs a simple questionnaire about the itchiness and quality of life and sends all the information to the doctor managing the case.

    In less than 23 seconds, the rash can be reported, avoiding unsatisfactory visits to the doctor where the severity of the flare has reduced by the time the patient arrives at the medical center.

    Do you want to see the Automatic SCORAD algorithms in action?

    5. Empowers the patient to take part in its own treatment

    One of the most reported misuses of the UAS7 is due to the inconvenience of this scoring system for the life of a patient that has to not only deal with an incapacitating and stressful condition but to daily remember to apply the scoring system in order to get good care from their doctors.

    The revolutionary app developed by Legit.Health makes sure that haphazardly filling out the UAS7 the day before the visit to the doctor has less of an excuse.

    Thanks to daily notifications and reminders, its accessibility, and its ease of use, Legit.Health makes recording data with the help of your patients easier than ever, by making them become an active part of their treatment and empowering them by improving the ever so important communication with their doctor.

    6. Makes the data easy to access and interpet

    Last but not least, Legit.Health‘s interface provides access to all the relevant information about the patient in an easy-to-read manner.

    Every data derived from the AUAS7 is clearly displayed on the screen, showing the severity of the affection and the different factors considered by the algorithm when analyzing the image and their punctuations.

    The app also provides a handy graff that shows the evolution of the disease across time and makes following the healing process and the effectiveness of the treatment really easy.

    AUAS7
    The easy-to-read interface of Legit.Health helps the doctor

    Do you want to see the Automatic UAS7 algorithms in action?

    Conclusion

    The revolutionary AUAS7 represents the future of dermatology. Allowing doctors across the globe to practice evidence-based medicine by using the best tool during the disease diagnosis while improving the effective communication between doctor and patient.

    Thanks to Legit.Health, doctors across the globe can improve their correct diagnosis rate by 23% and make treatment easier to follow for the patient by making them active participants in their own recovery.

    We cannot improve what we cannot measure, and thanks to AUAS7 and Legit.Health the future of the study and treatment of urticaria is brighter than ever.

    Get access now

    This free 23-day trial of Legit.Health gives clinics and hospitals a hands-on look at how to drive increased adherence and improve patient outcomes, as well as improving efficiency and overall quality of life.

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    AUAS7: the best weapon in the dermatologyst arsenal against urticaria
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