Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
Br J Dermatol. 2010 May;162(5):1030-7. doi: 10.1111/j.1365-2133.2010.09656.x. Epub 2010 Mar 1.
Discoid lupus erythematosus (DLE) is a disfiguring inflammatory skin disease. There is no specific tool for measuring disease severity.
To determine the features needed in a score measuring activity and damage in DLE and to investigate the score's reliability and its correlation with the physician's global assessment of disease severity and the patient-reported Dermatology Quality of Life Index (DLQI).
The content of the score was determined following a peer review, pilot work in patients and a preliminary inter-rater reliability study. The Score of Activity and Damage in DLE (SADDLE) measures severity of activity (erythema, scale, induration) and damage (scarring/atrophy and dyspigmentation) attributable to DLE. Summed scores range between 0 and 195. Inter- and intrarater reliability of the score was tested using six assessors and nine patients with DLE. Intraclass correlation coefficients (ICCs) > 0.7 were considered evidence of good inter- and intrarater agreement.
The mean +/- SD SADDLE score of nine patients in the inter-rater reliability study was 47 +/- 22 (range 14-102). There was good inter-rater agreement for the total score [ICC 0.82; 95% confidence interval (CI) 0.61-0.95] and for the activity and damage scales, the individual physical signs and the total scores at individual body sites. The total score demonstrated excellent intrarater reliability (ICC 0.98; 95% CI 0.86-1.00). Although there was poor inter-rater agreement for global assessments (ICC 0.28; 95% CI 0.06-0.66), a good correlation was demonstrated between total scores and global assessments (r = 0.7). A weaker positive correlation was observed between disease activity scores and DLQI (r = 0.4).
The SADDLE measures activity and damage in patients with DLE. It demonstrates good inter- and excellent intrarater agreement, over and above that for global assessment. It correlates well with global assessment scores. Further studies are required to investigate SADDLE's responsiveness to change with therapy.
盘状红斑狼疮（DLE）是一种影响容貌的炎症性皮肤病。目前还没有专门用于衡量疾病严重程度的工具。
确定衡量 DLE 活动和损害所需的评分特征，并研究该评分的可靠性及其与医生对疾病严重程度的总体评估和患者报告的皮肤病生活质量指数（DLQI）之间的相关性。
在同行评议、患者试点工作和初步的评估者间可靠性研究之后，确定了评分的内容。DLE 活动和损害评分（SADDLE）衡量的是由 DLE 引起的活动（红斑、鳞屑、硬结）和损害（瘢痕/萎缩和色素减退）的严重程度。总得分范围为 0 至 195 分。六位评估者和九位 DLE 患者用于测试评分的评估者间和评估者内可靠性。评估者间和评估者内的一致性好，组内相关系数（ICC）>0.7。
在评估者间可靠性研究中，九位患者的平均 +/- SD SADDLE 评分为 47 +/- 22（范围 14-102）。总评分的评估者间一致性较好[ICC 0.82；95%置信区间（CI）0.61-0.95]，活动和损害量表、各个体征以及各个身体部位的总分也具有较好的一致性。总评分的评估者内可靠性极好（ICC 0.98；95% CI 0.86-1.00）。尽管总体评估的评估者间一致性较差（ICC 0.28；95% CI 0.06-0.66），但总评分与总体评估之间显示出良好的相关性（r = 0.7）。疾病活动评分与 DLQI 之间的相关性较弱，为正相关（r = 0.4）。
SADDLE 可衡量 DLE 患者的活动和损害。它具有较好的评估者间和极好的评估者内一致性，超过了对总体评估的一致性。它与总体评估评分具有良好的相关性。还需要进一步的研究来调查 SADDLE 对治疗变化的反应性。
