Validity of the Fitzpatrick Skin Phototype Classification in Ecuador.
Martha Fors, Paloma González, Carmen Viada and 2 others
PMID 33208633WHAT IT FOUND
The Fitzpatrick self-report scale was most usable for sun-response questions in 254 Ecuadorian adults, mostly skin type IV.
Hair, eye, and freckle questions were weak, so a shorter 5-item version made more sense.
Key findings
01The full Fitzpatrick questionnaire had total internal consistency of .51, and the genetic-disposition items were nonsatisfactory.
02The sun-exposure subscale was more consistent than the genetic-disposition subscale, with Cronbach alpha values of .67 and .42.
03The freckle question should be disregarded because it loaded poorly, and removing it improved the scale's Cronbach alpha to .55.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The participants were all 40 years or older, from one rural high-UV area, and 71.3% were women, so results may not apply to younger people, men, or other regions. Almost all participants were skin type III or IV, and types I and VI were absent, limiting the scale's ability to separate different phototypes. The scale was self-reported, and the authors note that self-reported race and pigment phenotypes can be inaccurate predictors of sun sensitivity. The full scale did not meet all prespecified validity targets; the NNFI was 0.88, below the 0.90 acceptable value.
The easy way to misread this
Do not conclude that the Fitzpatrick scale is invalid for all dark-skinned patients or that the 5-item version is proven for clinical use. The study tested a self-report questionnaire in one mostly type III/IV, female, older Ecuadorian sample; the full scale had low internal consistency, and the authors only proposed a shorter version for this population.