Scoring Vitiligo Using PROM Instrument CV-6

A recent study evaluated the efficacy of the patient reported outcome measure instrument Clinical Evolution-Vitiligo for scoring nonsegmental vitiligo.

A recent study published in Dermatology examined the development and validation of a new scoring tool which aims to evaluate the clinical evolution of adult patients with nonsegmental vitiligo.1 Vitiligo, a pigmentary disorder, has unpredictable progression and uneven treatment response, meaning the improvement of some lesions through treatment cannot guarantee similar outcomes in others. Due to these irregularities, instruments for patient reported outcome measures (PROM) can be helpful alternatives to measure complex constructions like clinical evolution. 

In the study, investigators examined whether PROM allows for a simple but standardized way of evaluating the clinical evolution of patients and gathering information to better understand the disorder. To do this, a validation study was conducted with a prospective cohort design. Body surface area (BSA) affected was measured using the Vitiligo Extension Score (VES), and extension, stage, and spread was evaluated using the Vitiligo European Task Force assessment (VETFa). Additionally, the study “reliability was determined with test-retest, construct validity through hypothesis testing, discriminative capacity with extreme groups, and response capacity by comparing initial and final measurements,” wrote the investigators.

The PROM instrument Clinical Evolution-Vitiligo (CV-6) was answered by 119 patients with primary school as their minimum education. There were 18 semi-structured interviews and 7 cognitive interviews conducted. Also, 4 dermatologists were consulted, with a wide range of affected BSA observed—incident and prevalent cases were included.

“The average time to answer the CV-6 was 3.08 ± 0.58 min,” wrote the study investigators. “In the test-retest (n = 53), an intraclass correlation coefficient was obtained: 0.896 (95% CI 0.82–0.94; p < 0.001). In extreme groups, the mean score was 2 (2–3) and 5 (4–6); p < 0.001. The initial CV-6 score was different from the final one and the change was verified with VES and VETFa (p < 0.05, n = 92).”

The investigators concluded that the PROM instrument, CV-6 allows patients to collaborate with physicians when it comes to their personalized care, it was simple to use, and took only a brief time to fill out. Also, it made it easier for the physician to focus on any areas presenting changes at the time of medical consultation.


1. Peralta-Pedrero ML, Herrera-Bringas D, Torres-González KS, Morales-Sánchez MA, Jurado Santa-Cruz F, Cruz-Avelar A. Development and validation of a new scoring tool to evaluate the clinical evolution of adult patients with nonsegmental vitiligo. Dermatology. 2021;237(6):952-960. DOI: 10.1159/000511890