Using ADCT in clinical practice

Measuring outcomes in clinical practice can aid patient care quality improvement, and real-world evidence generation.

The Harmonising Outcome Measures for Eczema (HOME) initiative has identified symptoms and long-term control as the most important domains to measure in clinical practice.1 For long-term control HOME recommend the use of ADCT and Recap of atopic eczema (RECAP) eczema control instruments.

Atopic Dermatitis Control Tool (ADCT) has been validated for use in adult and adolescent patients (12 years and older) with atopic dermatitis.2

To use ADCT correctly, a patient must answer all six ADCT questions by selecting the most appropriate answer.

ATOPIC DERMATITS CONTROL TOOL (ADCT)

Please answer the following questions thinking about your experiences with eczema, sometimes called “atopic dermatitis”.

Calculating the ADCT score

Step 1: Each ADCT question is scored 0–4 points, as shown in the table above

Step 2: The sum of the scores from all six ADCT questions forms the ADCT total score

The minimum ADCT total score is 0, the maximum ADCT total score is 24

Interpreting the ADCT total score

Point‐in‐time control status
A higher score indicates lower atopic dermatitis control

A patient’s atopic dermatitis may not be well controlled if:

  • The ADCT total score is at least 7 points
Changes in control status over time
A change of 5 points is the threshold for meaningful within person change
  • Decrease of 5 points or more: indication of clinically relevant improvement of atopic dermatitis control
  • Increase of 5 points or more: indication of clinically relevant worsening of atopic dermatitis control

Engaging patients in a meaningful conversation about their perception of atopic dermatitis control across multiple domains

A patient’s atopic dermatitis may not be adequately controlled if:

  • Their ADCT total score is at least 7 points

or

  • Their ADCT total score increases by 5 points or more since they last used ADCT

ADCT can be used to detect change over time supporting a patient-physician conversation on sustained control in clinical practice.

Footnotes
  • Leshem Y, et al. Measuring Atopic Eczema Control and Itch Intensity in Clinical Practice: A Consensus Statement From the Harmonising Outcome Measures for Eczema in Clinical Practice (HOME-CP) Initiative. Clinical Review and Education (2022) doi: 10.1001/jamadermatol.2022.4211
  • Pariser DM, et al. Evaluating patient-perceived control of atopic dermatitis: design, validation, and scoring of the Atopic Dermatitis Control Tool (ADCT). Curr Med Res Opin (2019) doi:10.1080/03007995.2019.1699516