POEM (Patient-Oriented Eczema Measure)

POEM is patient-reported and captures symptom frequency (itching, sleep loss, visible signs as the patient perceives them) over the past week. SCORAD and EASI are clinician-assessed and measure objective extent and sign intensity at the time of examination. POEM reflects the patient's subjective burden and is useful for tracking change at home. SCORAD and EASI are better for precise severity grading at baseline and for trial outcomes requiring blinded clinician assessment.

POEM should complement, not replace, objective measures in clinical trials. Modern trial designs use both: POEM (patient-reported) and EASI (clinician-assessed) as co-primary efficacy endpoints. In routine practice, POEM alone is adequate for home monitoring and telemedicine; however, baseline assessment should include an objective measure to document disease severity at the start of treatment.

The MCID for POEM is approximately 3 points; a reduction of ≥3 points from baseline is considered clinically meaningful improvement. Additionally, a 50% reduction in POEM score (POEM-50 response) is used in some trials as a secondary efficacy endpoint.

Yes, POEM is validated for children aged 2–16 years using parental proxy completion. However, parents' perception of symptoms (particularly itching severity and sleep disruption) may differ from direct observation. For children aged 6+, direct child self-report is encouraged when feasible. For infants under 2 years, POEM is not validated; objective measures are preferred.

POEM asks about symptoms during the past 7 days. For frequent assessments (weekly), this is straightforward. For less frequent monitoring (monthly), the recall period may be extended, but this should be clearly documented and reported. Always state the recall period when reporting POEM scores to enable comparison across studies.