Topic 6: Outcome Measures Support Clinical Judgment
| Measure | Evaluates | Practical role | Limitation |
| IHS4 | Nodules, abscesses, and draining tunnels | Classifies dynamic inflammatory activity and tracks change | Does not include nondraining tunnels, scarring, pain, or quality of life |
| Hurley staging | Tunnels, scarring, and regional structural disease | Quickly communicates accumulated structural damage | Relatively static and completely insensitive to inflammation |
| Refined Hurley | More detailed disease characteristics within Hurley stages | Can support treatment and surgical planning | More complex and not a direct measure of patient burden |
| HS-PGA | Physician-rated severity based mainly on lesion counts | Provides a clinician global assessment | Does not include any patient-reported outcomes |
| Patient Global Assessment | Patient’s overall perception of severity or change | Captures the patient’s experience simply | Does not identify which symptoms drive the rating |
| HiSQOL | HS-specific symptoms, psychosocial effects, and activity adaptations | Captures disease-specific quality-of-life burden | May not be practical at every visit |
| DLQI | General dermatology-related quality of life | Familiar and widely used across skin diseases | May miss HS-specific concerns such as drainage, odor, and dressings |
A consensus statement from a group of HS experts recommended practical outcome measures for evaluating treatment response in routine clinical care, reflecting the need to assess both clinician-reported activity and patient-reported outcomes.3
The 17-item HiSQOL evaluates symptoms, psychosocial effects, and activities or adaptations over the previous seven days. Higher scores indicate greater impairment. Recent validation supports its ability to distinguish levels of HS-related impact and detect meaningful change.8