Development and initial validation of the localized scleroderma skin damage index and physician global assessment of disease damage: a proof-of-concept study
Autor: | Kathryn S. Torok, Soamarat Vilaiyuk, Thomas A. Medsger, Thaschawee Arkachaisri |
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Rok vydání: | 2009 |
Předmět: |
Male
medicine.medical_specialty Adolescent Psychometrics Pilot Projects Severity of Illness Index Scleroderma Localized Atrophy Rheumatology Medicine Humans Pharmacology (medical) Localized Scleroderma Child Reliability (statistics) Skin damage Observer Variation integumentary system business.industry Reproducibility of Results Dermatology Life Quality Index Clinical Science medicine.disease Dermatology Disease damage Clinical trial Child Preschool Physical therapy Quality of Life Dermal atrophy Female business |
Zdroj: | Rheumatology (Oxford, England). 49(2) |
ISSN: | 1462-0332 |
Popis: | Objective. To develop and assess the psychometric properties of the Localized Scleroderma (LS) Skin Damage Index (LoSDI) and Physician Global Assessment of disease Damage (PGA-D). Methods. Damage was defined as irreversible/persistent changes (>6 months) due to previous active disease/complications of therapy. Eight rheumatologists assessed the importance of 17 variables in formulating the PGA-D/LoSDI. LS patients were evaluated by two rheumatologists using both tools to assess their psychometric properties. LoSDI was calculated by summing three scores for cutaneous features of damage [dermal atrophy (DAT), subcutaneous atrophy (SAT) and dyspigmentation (DP)] measured at 18 anatomic sites. Patient GA of disease severity (PtGA-S), Children’s Dermatology Life Quality Index (CDLQI) and PGA-D were recorded at the time of each examination. Results. Thirty LS patients (112 lesions) and nine patient-visit pairs (18 lesions) were included for inter- and intra-rater reliability study. LoSDI and its domains DAT, SAT, DP and PGA-D demonstrated excellent inter- and intra-rater reliability (reliability coefficients 0.86–0.99 and 0.74–0.96, respectively). LoSDI correlated moderately with PGA-D and poorly with PtGA-S and CDLQI. PGA-D correlated moderately with PtGA-S, but poorly with CDLQI. Conclusions. To complete the LS Cutaneous Assessment Tool (LoSCAT), we developed and evaluated the psychometric properties of the LoSDI and PGA-D in addition to the LS Skin Severity Index (LoSSI). These instruments will facilitate evaluation of LS patients for individual patient management and clinical trials. LoSDI and PGA-D demonstrated excellent reliability and high validity. LoSCAT provides an improved understanding of LS natural history. Further study in a larger group of patients is needed to confirm these preliminary findings. |
Databáze: | OpenAIRE |
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