Ocular and oral grading of mucous membrane pemphigoid
| Autor: | Graham M. B. Reeves, Gillian L. Barker, E. Anne Field, Marianne Lloyd, Stephen B. Kaye, Bijay Rajlawat |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Pemphigoid medicine.medical_specialty Pemphigoid Benign Mucous Membrane Severity of Illness Index Conjunctival Diseases Cellular and Molecular Neuroscience Cohen's kappa Severity of illness Medicine Humans Oral mucosa Grading (education) Aged Aged 80 and over Observer Variation Mucous Membrane business.industry Mouth Mucosa Middle Aged medicine.disease Dermatology eye diseases Sensory Systems Confidence interval Ophthalmology medicine.anatomical_structure Mucous membrane pemphigoid Female business Mouth Diseases Oral medicine Conjunctiva |
| Zdroj: | Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. 250(4) |
| ISSN: | 1435-702X |
| Popis: | A variety of methods have been described for grading ocular mucous membrane pemphigoid (MMP), each with their own limitations. In contrast, there are no reported grading systems for involvement of the oral mucosa. We wished to evaluate two ocular (one established and one proposed) and an oral mucosal grading system for MMP. Patients with MMP were assessed by three ophthalmologists and two oral medicine physicians. Ocular disease was graded using the system described by Rowsey and a proposed system based on measurement of vertical depth and horizontal width measured from the bulbar conjunctival aspect. Oral assessment used a ‘mucosal disease severity score’ originally described for lichen planus, in which 17 areas of the mouth are scored for involvement, together with a pain score. Levels of agreement were evaluated using Fleiss’ Kappa Statistic (k). Forty-four patients with MMP encompassing mild to severe disease were included. Good levels of agreement were observed between observers for both vertical (k:0.86) (upper 95% CI: 1.03 mm) and horizontal (k:0.80) (upper 95% CI: 3.01 mm) involvement for the proposed ocular system and the Rowsey system (k: 0.83) (upper 95% confidence interval: 3.19 mm). There was a high coefficient of determination (R2) between the ocular grading systems (0.81, p |
| Databáze: | OpenAIRE |
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