Veterans Affairs Medical Center, University of Pennsylvania, Philadelphia, PA 19104-2676, USA.
Br J Dermatol. 2010 Mar;162(3):669-73. doi: 10.1111/j.1365-2133.2009.09521.x. Epub 2009 Oct 26.
Validated outcome measures in dermatology help standardize and improve patient care. A scoring system of skin disease severity in dermatomyositis known as the Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI) has been developed.
To simplify and improve the tool for clinical research and care, we modified the CDASI and validated the new version, v2.
The original CDASI has four activity and two damage measures. The modified CDASI has three activity and two damage measures. The skin disease of 20 patients with dermatomyositis was evaluated by the same dermatologist using both the original and the modified CDASI. Global validation measures were implemented to assess overall skin disease state, skin disease activity and skin damage. Spearman's rho (r(sp)), adjusted for multiple observations on subjects, was used to determine the relationship between the two versions of the CDASI and their correlation with the physician global measures (PGMs).
The total score and activity and damage subscores of the original and the modified CDASI correlated perfectly with each other (r(sp) = 0.99, 1.00, 1.00). The PGM-overall skin scale correlated with the total scores (r(sp) = 0.72, r(sp) = 0.76) and activity subscores (r(sp) = 0.68, r(sp) = 0.63) but not with the damage subscores (r(sp) = 0.14, r(sp) = 0.15) of the original and the modified CDASI, respectively. However, the PGM-activity and PGM-damage scales correlated with the activity (r(sp) = 0.76, r(sp) = 0.75) and damage subscores (r(sp) = 0.90, r(sp) = 0.90), respectively, of the original and the modified CDASI.
The modified CDASI is perfectly correlated with the original CDASI. It has equally good concurrent validity with the PGM-overall skin and PGM-activity scales. The CDASI subscores have equally good concurrent validity with the PGM-activity and PGM-damage scales. We suggest that PGMs of skin disease activity and damage should be assessed separately for greater specificity. The modified CDASI is a refined and equally as useful outcome measure.
在皮肤病学中，经过验证的结局测量有助于标准化和改善患者护理。已经开发出一种用于评估皮肌炎皮肤疾病严重程度的评分系统，称为皮肤肌炎疾病面积和严重程度指数（CDASI）。
为了简化和改进用于临床研究和护理的工具，我们修改了 CDASI 并验证了新版本 v2。
原始的 CDASI 有四个活动和两个损伤测量指标。改良的 CDASI 有三个活动和两个损伤测量指标。同一位皮肤科医生使用原始和改良的 CDASI 评估了 20 例皮肌炎患者的皮肤疾病。实施了全球验证措施，以评估整体皮肤疾病状态、皮肤疾病活动度和皮肤损伤。使用斯皮尔曼 rho（r(sp)），调整了受试者的多次观察，以确定两种版本的 CDASI 之间的关系及其与医生整体评估（PGM）的相关性。
原始和改良的 CDASI 的总分和活动及损伤子评分彼此完美相关（r(sp) = 0.99、1.00、1.00）。PGM-总体皮肤评分与总分（r(sp) = 0.72、r(sp) = 0.76）和活动子评分（r(sp) = 0.68、r(sp) = 0.63）相关，但与原始和改良的 CDASI 的损伤子评分不相关（r(sp) = 0.14、r(sp) = 0.15）。然而，PGM-活动和 PGM-损伤量表与原始和改良的 CDASI 的活动（r(sp) = 0.76、r(sp) = 0.75）和损伤子评分（r(sp) = 0.90、r(sp) = 0.90）相关。
改良的 CDASI 与原始的 CDASI 完美相关。它与 PGM-总体皮肤和 PGM-活动量表具有同等的良好一致性。CDASI 子评分与 PGM-活动和 PGM-损伤量表具有同等的良好一致性。我们建议，为了提高特异性，应分别评估皮肤疾病活动度和损伤度的 PGM。改良的 CDASI 是一种更精细且同样有用的结局测量。
