How Robust are the Dermatology Life Quality Index and Other Self-reported Subjective Symptom Scores when Exposed to a Range of Experimental Biases?

Subjective-symptom tools used in dermatology have rarely been experimentally tested for cognitive "focus" and "framing" biases. We investigated the effects of affective biases on the Dermatology Life Quality Index (DLQI), the Global Health Question and visual analogue scores. Two experiments tested the response to affect-eliciting words and film. We demonstrated no significant difference in median DLQI scores for subjects exposed to negative vs. neutral words (medians 8.5 and 9.5, respectively), or negative vs. positive words (medians 6.0 and 9.0, respectively, overall p=0.41.) Median DLQI scores were similar for groups who had (8.0), or had not (9.0), seen a video clip about a severe skin condition (p=0.34). Finally, we compared an Amended DLQ1 (ADLQI), the DLQI re-worded into neutral "frames", with the standard DLQ1. ADLQI median scores were higher (ADLQI 8.25, DLQI 6.75), but not significantly so (p=0.47). We have been unable to demonstrate any effects of the biases studied, but the statistical power of our study is modest.