Evaluation of the reliability of the Cutaneous Dermatomyositis Disease Area and Severity Index and the Cutaneous Assessment Tool–Binary Method in juvenile dermatomyositis among paediatric dermatologists, rheumatologists and neurologists. (31st July 2017)

• Record Type: Journal Article
• Authors: Tiao, J.; Feng, R.; Berger, E.M.; Brandsema, J.F.; Coughlin, C.C.; Khan, N.; Kichula, E.A.; Lerman, M.A.; Lvovich, S.; McMahon, P.J.; Rider, L.G.; Rubin, A.I.; Scalzi, L.V.; Smith, D.M.; Taxter, A.J.; Treat, J.R.; Williams, R.P.; Yum, S.W.; Okawa, J.; Werth, V.P.
• Is Part Of: British journal of dermatology. Volume 177:Number 4(2017)
• Page Start: 1086
• Page End: 1092
• Publication Date: 2017-07-31
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.15596
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: The Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) and Cutaneous Assessment Tool–Binary Method (CAT‐BM) have been shown to be reliable and valid outcome measures to assess cutaneous disease in adult dermatomyositis (DM) and juvenile DM (JDM), respectively. Objectives: This study compared the CDASI and CAT‐BM for use by paediatric dermatologists, paediatric rheumatologists and paediatric neurologists in patients with JDM. Methods: Five paediatric dermatologists, five paediatric rheumatologists and five paediatric neurologists each evaluated 14 patients with JDM using the CDASI, CAT‐BM, and skin Physician Global Assessment (PGA) scales. Inter‐rater reliability, intra‐rater reliability, construct validity and completion time were compared. Results: Inter‐rater reliability for CDASI activity and damage scores was good to moderate for paediatric dermatologists and rheumatologists, but poor for paediatric neurologists. The inter‐rater reliability for CAT‐BM activity scores was moderate for paediatric dermatologists and rheumatologists, but poor for paediatric neurologists and poor across all specialties for damage scores. Intra‐rater reliability for the CDASI and CAT‐BM activity and damage scores was moderate to excellent for paediatric dermatologists, rheumatologists and neurologists. Strong associations were found between skin PGA activity and damage scores and CDASI or CAT‐BM activity and damage scores, respectively ( P < 0·002). The CDASI had a mean completion time of 5·4 min compared with that for the CAT‐BM of 3·1 min. Conclusions: Our data confirm the reliability of the CDASI activity and damage scores and the CAT‐BM activity scores when used by paediatric dermatologists and rheumatologists in assessing JDM. Significant variation existed in the paediatric neurologists' scores. Abstract : What's already known about this topic? The Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) was developed by dermatologists as a reliable and valid outcome measure to assess cutaneous disease in adult dermatomyositis (DM). The Cutaneous Assessment Tool–Binary Method (CAT‐BM) was similarly developed by paediatric rheumatologists for use in juvenile DM (JDM). What does this study add? This study expands the application of the CDASI activity and damage scores for use in patients with JDM when performed by paediatric dermatologists and rheumatologists. This study also finds that CAT‐BM activity scores are reliable when used by paediatric dermatologists and rheumatologists to assess skin findings in patients with JDM. Respond to this article