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The reliability of the Cutaneous Dermatomyositis Disease Area and Severity Index ( CDASI ) among dermatologists, rheumatologists and neurologists
Author(s) -
Tiao J.,
Feng R.,
Bird S.,
Choi J.K.,
Dunham J.,
George M.,
GonzalezRivera T.C.,
Kaufman J.L.,
Khan N.,
Luo J.J.,
Micheletti R.,
Payne A.S.,
Price R.,
Quinn C.,
Rubin A.I.,
Sreih A.G.,
Thomas P.,
Okawa J.,
Werth V.P.
Publication year - 2017
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.15140
Subject(s) - medicine , dermatomyositis , intraclass correlation , inter rater reliability , rheumatology , intra rater reliability , dermatology , physical therapy , reliability (semiconductor) , disease , confidence interval , rating scale , psychometrics , psychology , clinical psychology , developmental psychology , power (physics) , physics , quantum mechanics
Summary 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 ( ICC s) for interrater reliability for CDASI activity and damage were good to excellent for dermatologists and rheumatologists, and moderate to excellent for neurologists. The ICC s 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.