Development and initial validation of the Localized Scleroderma Skin Damage Index and Physician Global Assessment of disease Damage: a proof-of-concept study
Open Access
- 14 December 2009
- journal article
- research article
- Published by Oxford University Press (OUP) in Rheumatology
- Vol. 49 (2), 373-381
- https://doi.org/10.1093/rheumatology/kep361
Abstract
Objective. To develop and assess the psychometric properties of the Localized Scleroderma (LS) Skin Damage Index (LoSDI) and Physician Global Assessment of disease Damage (PGA-D). Methods. Damage was defined as irreversible/persistent changes (>6 months) due to previous active disease/complications of therapy. Eight rheumatologists assessed the importance of 17 variables in formulating the PGA-D/LoSDI. LS patients were evaluated by two rheumatologists using both tools to assess their psychometric properties. LoSDI was calculated by summing three scores for cutaneous features of damage [dermal atrophy (DAT), subcutaneous atrophy (SAT) and dyspigmentation (DP)] measured at 18 anatomic sites. Patient GA of disease severity (PtGA-S), Children's Dermatology Life Quality Index (CDLQI) and PGA-D were recorded at the time of each examination. Results. Thirty LS patients (112 lesions) and nine patient-visit pairs (18 lesions) were included for inter- and intra-rater reliability study. LoSDI and its domains DAT, SAT, DP and PGA-D demonstrated excellent inter- and intra-rater reliability (reliability coefficients 0.86–0.99 and 0.74–0.96, respectively). LoSDI correlated moderately with PGA-D and poorly with PtGA-S and CDLQI. PGA-D correlated moderately with PtGA-S, but poorly with CDLQI. Conclusions. To complete the LS Cutaneous Assessment Tool (LoSCAT), we developed and evaluated the psychometric properties of the LoSDI and PGA-D in addition to the LS Skin Severity Index (LoSSI). These instruments will facilitate evaluation of LS patients for individual patient management and clinical trials. LoSDI and PGA-D demonstrated excellent reliability and high validity. LoSCAT provides an improved understanding of LS natural history. Further study in a larger group of patients is needed to confirm these preliminary findings.Keywords
This publication has 22 references indexed in Scilit:
- The Children's Dermatology Life Quality Index (CDLQI): initial validation and practical useBritish Journal of Dermatology, 2010
- The Localized Scleroderma Skin Severity Index and Physician Global Assessment of Disease Activity: A Work in Progress Toward Development of Localized Scleroderma Outcome MeasuresThe Journal of Rheumatology, 2009
- Development of outcome measures for autoimmune dermatosesArchiv für dermatologische Forschung, 2007
- Is the CVI an acceptable indicator of content validity? Appraisal and recommendationsResearch in Nursing & Health, 2007
- Ultrasonography is a sensitive tool for monitoring localized sclerodermaRheumatology, 2007
- Ultrasound as an outcome measure to assess disease activity in disorders of skin thickening: an example of the use of radiologic techniques to assess skin diseaseDermatologic Therapy, 2007
- The content validity index: Are you sure you know what's being reported? critique and recommendationsResearch in Nursing & Health, 2006
- Measurement of body surface area involvement in atopic eczema: an impossible task?British Journal of Dermatology, 1999
- Measurement of disease activity and outcome in atopic dermatitisBritish Journal of Dermatology, 1996
- Atrophoderma of Pasini and Pierini: Clinical and histopathologic findings and antibodies to Borrelia burgdorferi in thirty-four patientsJournal of the American Academy of Dermatology, 1994