Naildex: pilot evaluation of an onychodystrophy severity instrument.

Journal Article (Journal Article)

A valid and reliable measure that captures onychodystrophy disease severity is important for both clinical and research applications. Three hundred and twenty-two patients at two Veterans Affairs Medical Centers with clinical evidence of onychodystrophy suggesting onychomycosis (at least 25% in a distal subungual pattern) were examined using Naildex parameters. Naildex scores were calculated by a combination of: per cent of each nail infected, area of each nail and number of infected nails. Patients also completed a nail-specific quality of life questionnaire (NailQoL) and nail samples were collected and examined mycologically. Data was analysed for all enrolled patients (n = 322) and patients with mycologically-confirmed onychomycosis (n = 243). Inter-rater reliability was calculated from two examiners who each evaluated 17 patients with mycologically-confirmed onychomycosis. Significant correlations (P < 0.01) between Naildex and NailQoL as well as proxy measures (duration of infection) indicated construct validity of the instrument for all patients as well as mycologically-confirmed cases. Strong correlation (r = 0.754, P < 0.01, n = 17) indicated high inter-rate reliability. This pilot evaluation suggests that Naildex is a valid and reliable measure of onychomycosis severity.

Full Text

Duke Authors

Cited Authors

  • Warshaw, EM; Traywick, CA; Hoffman, AA; Lilly, KK; Koshnick, RL; Robinson, JW; Suwattee, P; Foster, JK; Chen, SC

Published Date

  • January 2008

Published In

Volume / Issue

  • 51 / 1

Start / End Page

  • 14 - 20

PubMed ID

  • 18076590

International Standard Serial Number (ISSN)

  • 0933-7407

Digital Object Identifier (DOI)

  • 10.1111/j.1439-0507.2007.01444.x


  • eng

Conference Location

  • Germany