Chronic pruritus is one of the most common symptoms for both skin and systemic diseases as well as adverse events of medications. Chronic pruritus is shown to have considerable impact on sufferers. Clinical trial outcome measures specifically targeted to chronic pruritus are in their infancy for adult patients, but are virtually non-existent for children. We propose to further develop two pediatric versions of the ItchyQoL and the ItchyQuant. The ItchyQoL is a validated pruritus-specific quality of life measure that is widely used for clinical trials and epidemiological studies in adults. We have preliminary pediatric versions of the ItchyQoL: KidsItchyQoL for older (ages 8-17 years) children and TotsItchyQoL, a cartoon version for younger children (ages 4-7 years). The ItchyQuant is a cartoon version of the adult 10-point numeric rating scale to self-rate itch severity. We propose to demonstrate the psychometric properties of all three instruments by enrolling itchy children into a survey study. The instruments will be administered three times in order to test for validity reliability, and responsiveness. We also propose to harness an electronic platform for the instruments such that mobile technology can be utilized in the field to capture ItchyQoL and ItchyQuant data. These outcome instruments are generalizable to any situation or disease that causes pruritus. The electronic platform will enable the instruments to be deployed widely. Sensitive measures to changes in pruritus will be invaluable in drug development as there are many diseases that affect children where the primary symptom is pruritus. Self-rated severity and burden of pruritus are important in epidemiological studies of pediatric diseases which itch. Lastly, the instruments, specifically the ItchyQuant, may be used in the patient care arena as a "vital sign", similarly to how the pain scale is currently utilized. All of these applications are relevant to the interests of NIAMS.
Itch is a very big problem because there are few drugs that can help it, particularly in children. Since itch cannot be seen, it is hard to develop drugs;doctors need to rely on the patients'description. This study proposes to develop instruments that can accurately quantify the severity and impact of itch in children, and ultimately be used in drug development.