Key result
Maximum and binary scoring methods of the Cutaneous Assessment Tool strongly correlated with the original method for activity and damage scores.
Why the study?
Do alternative scoring methods (maximum and binary) for the Cutaneous Assessment Tool perform similarly to the original method in children with juvenile dermatomyositis?
Observational (n=113)
Do alternative scoring methods (maximum and binary) for the Cutaneous Assessment Tool perform similarly to the original method in children with juvenile dermatomyositis?
Abbreviated scoring methods (maximum and binary) for the Cutaneous Assessment Tool have similar measurement characteristics to the original method, potentially increasing clinical acceptability.
Answers are grounded in this paper and cite their sources.
May support simpler scoring in juvenile dermatomyositis practice; extends validation of alternative methods but leaves adoption open.
OBJECTIVE: The Cutaneous Assessment Tool (CAT) is a comprehensive, semiquantitative tool for the assessment of skin disease in juvenile dermatomyositis (DM). The goal of this study was to determine whether alternative scoring methods would shorten the CAT without compromising its measurement characteristics. METHODS: A total of 113 children with juvenile DM were assessed at baseline; 94 were assessed again 7-9 months later. Interrater reliability, internal consistency, construct validity, and responsiveness were obtained using the original scoring method and 2 alternative methods: the maximum and binary scoring methods. RESULTS: Spearman's correlations of the maximum and binary methods with the original were both 0.98 (P < 0.0001) for the CAT activity score, and 0.96 and 0.98, respectively (P < 0.0001), for the CAT damage score. Values obtained for interrater reliability, internal consistency, construct validity, and responsiveness were similar for all 3 scoring methods. Although there was a trend toward the maximum method having higher interrater reliability and the binary method having higher responsiveness, the confidence intervals were overlapping and no statistically significant differences were observed. Correlation coefficients for the 3 scoring methods with other measures of myositis disease activity and damage were very similar. CONCLUSION: The maximum and binary methods of scoring the CAT have measurement characteristics similar to the original method. Adoption of one of these abbreviated scoring methods should increase its acceptability to clinicians and researchers.
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Huber et al. (2008) conducted an observational in juvenile dermatomyositis (n=113). Maximum and binary scoring methods of the Cutaneous Assessment Tool vs. Original scoring method was evaluated on Spearman's correlations of the maximum and binary methods with the original for the CAT activity and damage scores (Spearman's correlation 0.96 to 0.98, p=< 0.0001). Maximum and binary scoring methods of the Cutaneous Assessment Tool strongly correlated with the original method for activity and damage scores.
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