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Tiao J, Feng R, Bird S, Choi JK, Dunham J, George M, Gonzalez-Rivera TC, Kaufman JL, Khan N, Luo JJ, Micheletti R, Payne AS, Price R, Quinn C, Rubin AI, Sreih AG, Thomas P, Okawa J, Werth VP. The reliability of the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) among dermatologists, rheumatologists and neurologists. Br J Dermatol 2016; 176:423-430. [PMID: 28004387 DOI: 10.1111/bjd.15140] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous studies have shown that skin disease in dermatomyositis (DM) is best assessed using the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI). Although the CDASI has been validated for use by dermatologists, it has not been validated for use by other physicians such as rheumatologists and neurologists, who also manage patients with DM and assess skin activity in clinical trials. OBJECTIVES To assess the reliability of the CDASI among dermatologists, rheumatologists and neurologists. METHODS Fifteen patients with cutaneous DM were assessed using the CDASI and the Physician Global Assessment (PGA) by five dermatologists, five rheumatologists and five neurologists. RESULTS The mean CDASI activity scores for dermatologists, rheumatologists and neurologists were 21·0, 21·8 and 20·8, respectively. These mean scores were not different among the specialists. The CDASI damage score means for dermatologists, rheumatologists and neurologists were 5·3, 7·0 and 4·8, respectively. The mean scores between dermatologists and rheumatologists were significantly different, but the means between dermatologists and neurologists were not. The intraclass correlation coefficients (ICCs) for interrater reliability for CDASI activity and damage were good to excellent for dermatologists and rheumatologists, and moderate to excellent for neurologists. The ICCs for intrarater reliability for CDASI activity and damage were excellent for dermatologists and rheumatologists and moderate to excellent for neurologists. The PGA displayed lower interrater and intrarater reliability relative to the CDASI. CONCLUSIONS Our results confirm the reliability of the CDASI when used by dermatologists and rheumatologists. The data for its use by neurologists were not as robust.
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Affiliation(s)
- J Tiao
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A.,Corporal Michael J. Crescenz Veterans Affairs Medical Center (Philadelphia), Philadelphia, PA, U.S.A
| | - R Feng
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, U.S.A
| | - S Bird
- Department of Neurology Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A
| | - J K Choi
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A.,Corporal Michael J. Crescenz Veterans Affairs Medical Center (Philadelphia), Philadelphia, PA, U.S.A
| | - J Dunham
- Division of Rheumatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A
| | - M George
- Division of Rheumatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A
| | - T C Gonzalez-Rivera
- Division of Rheumatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A.,Department of Neurology, GlaxoSmithKline USA, Philadelphia, PA, U.S.A
| | - J L Kaufman
- Department of Neurology Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A
| | - N Khan
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A.,Corporal Michael J. Crescenz Veterans Affairs Medical Center (Philadelphia), Philadelphia, PA, U.S.A
| | - J J Luo
- Department of Neurology, Temple University School of Medicine, Philadelphia, PA, U.S.A
| | - R Micheletti
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A
| | - A S Payne
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A
| | - R Price
- Department of Neurology Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A
| | - C Quinn
- Department of Neurology Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A
| | - A I Rubin
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A
| | - A G Sreih
- Division of Rheumatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A
| | - P Thomas
- Division of Rheumatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A
| | - J Okawa
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A
| | - V P Werth
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, U.S.A.,Corporal Michael J. Crescenz Veterans Affairs Medical Center (Philadelphia), Philadelphia, PA, U.S.A
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