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

J. Tiao, R. Feng, E. M. Berger, J. F. Brandsema, C. C. Coughlin, N. Khan, E. A. Kichula, M. A. Lerman, S. Lvovich, P. J. McMahon, L. G. Rider, A. I. Rubin, L. V. Scalzi, D. M. Smith, A. J. Taxter, J. R. Treat, R. P. Williams, S. W. Yum, J. Okawa, V. P. Werth

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)1086-1092
Number of pages7
JournalBritish Journal of Dermatology
Volume177
Issue number4
DOIs
StatePublished - Oct 2017

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Dermatomyositis
Skin Diseases
Pediatrics
Skin
Rheumatologists
Neurologists
Dermatologists
Juvenile dermatomyositis
Physicians
Reproducibility of Results

All Science Journal Classification (ASJC) codes

  • Dermatology

Cite this

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. / 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. In: British Journal of Dermatology. 2017 ; Vol. 177, No. 4. pp. 1086-1092.
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title = "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",
abstract = "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.",
author = "J. Tiao and R. Feng and Berger, {E. M.} and Brandsema, {J. F.} and Coughlin, {C. C.} and N. Khan and Kichula, {E. A.} and Lerman, {M. A.} and S. Lvovich and McMahon, {P. J.} and Rider, {L. G.} and Rubin, {A. I.} and Scalzi, {L. V.} and Smith, {D. M.} and Taxter, {A. J.} and Treat, {J. R.} and Williams, {R. P.} and Yum, {S. W.} and J. Okawa and Werth, {V. P.}",
year = "2017",
month = "10",
doi = "10.1111/bjd.15596",
language = "English (US)",
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Tiao, J, Feng, R, Berger, EM, Brandsema, JF, Coughlin, CC, Khan, N, Kichula, EA, Lerman, MA, Lvovich, S, McMahon, PJ, Rider, LG, Rubin, AI, Scalzi, LV, Smith, DM, Taxter, AJ, Treat, JR, Williams, RP, Yum, SW, Okawa, J & Werth, VP 2017, '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', British Journal of Dermatology, vol. 177, no. 4, pp. 1086-1092. https://doi.org/10.1111/bjd.15596

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. / 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.

In: British Journal of Dermatology, Vol. 177, No. 4, 10.2017, p. 1086-1092.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 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

AU - Tiao, J.

AU - Feng, R.

AU - Berger, E. M.

AU - Brandsema, J. F.

AU - Coughlin, C. C.

AU - Khan, N.

AU - Kichula, E. A.

AU - Lerman, M. A.

AU - Lvovich, S.

AU - McMahon, P. J.

AU - Rider, L. G.

AU - Rubin, A. I.

AU - Scalzi, L. V.

AU - Smith, D. M.

AU - Taxter, A. J.

AU - Treat, J. R.

AU - Williams, R. P.

AU - Yum, S. W.

AU - Okawa, J.

AU - Werth, V. P.

PY - 2017/10

Y1 - 2017/10

N2 - 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.

AB - 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.

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DO - 10.1111/bjd.15596

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