Pediatric Rheumatology

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Preliminary validation and clinical meaning of the cutaneous assessment tool in juvenile dermatomyositis

  1. Adam M. Huber1,*,
  2. Elizabeth M. Dugan2,
  3. Peter A. Lachenbruch3,†,
  4. Brian M. Feldman4,
  5. Maria D. Perez5,
  6. Lawrence S. Zemel6,
  7. Carol B. Lindsley7,
  8. Robert M. Rennebohm8,
  9. Carol A. Wallace9,
  10. Murray H. Passo10,
  11. Ann M. Reed11,
  12. Suzanne L. Bowyer12,
  13. Susan H. Ballinger12,
  14. Frederick W. Miller13,
  15. Lisa G. Rider13,
  16. Juvenile Dermatomyositis Disease Activity Collaborative Study Group

Article first published online: 31 JAN 2008

DOI: 10.1002/art.23340

Issue

Arthritis Care & Research

Arthritis Care & Research

Volume 59, Issue 2, pages 214–221, 15 February 2008

Additional Information

How to Cite

Huber, A. M., Dugan, E. M., Lachenbruch, P. A., Feldman, B. M., Perez, M. D., Zemel, L. S., Lindsley, C. B., Rennebohm, R. M., Wallace, C. A., Passo, M. H., Reed, A. M., Bowyer, S. L., Ballinger, S. H., Miller, F. W., Rider, L. G. and Juvenile Dermatomyositis Disease Activity Collaborative Study Group (2008), Preliminary validation and clinical meaning of the cutaneous assessment tool in juvenile dermatomyositis. Arthritis & Rheumatism, 59: 214–221. doi: 10.1002/art.23340

Author Information

  1. 1

    IWK Health Centre and Dalhousie University, Halifax, Nova Scotia, Canada

  2. 2

    Washington Hospital Center, Washington, DC

  3. 3

    Center for Biologics Evaluation and Research, FDA, Rockville, Maryland

  4. 4

    Hospital For Sick Children and University of Toronto, Toronto, Ontario, Canada

  5. 5

    Texas Children's Hospital and Baylor College of Medicine, Houston, Texas

  6. 6

    Connecticut Children's Medical Center and University of Connecticut, Hartford

  7. 7

    University of Kansas, Kansas City

  8. 8

    Columbus Children's Hospital and Ohio State University, Columbus

  9. 9

    Children's Hospital and University of Washington, Seattle

  10. 10

    Children's Hospital and University of Cincinnati, Cincinnati, Ohio

  11. 11

    Mayo Clinic, Rochester, Minnesota

  12. 12

    Riley Children's Hospital and Indiana University School of Medicine, Indianapolis

  13. 13

    Environmental Autoimmunity Group, National Institute of Environmental Health Sciences, NIH, Bethesda, Maryland

  1. †

    Oregon State University, Corvallis

*Division of Pediatric Rheumatology, IWK Health Centre, 5850 University Avenue, Halifax, Nova Scotia, Canada, B3K 6R8

Publication History

  1. Issue published online: 31 JAN 2008
  2. Article first published online: 31 JAN 2008
  3. Manuscript Accepted: 13 AUG 2007
  4. Manuscript Received: 31 JAN 2007

Funded by

  • Intramural research programs of the National Institute of Environmental Health Sciences and the National Institute of Arthritis and Skin and Musculoskeletal Diseases
  • NIH
  • Department of Health and Human Services, Bethesda, Maryland

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Abstract

Objective

To provide preliminary validation of the Cutaneous Assessment Tool (CAT), a new tool to assess cutaneous manifestations of juvenile dermatomyositis (DM), and to explore the clinical meaning of CAT scores.

Methods

Children with juvenile DM (n = 113) were assessed at baseline and 7–9 months later (n = 94). Internal consistency, redundancy, construct validity, and responsiveness of the CAT were examined. CAT scores corresponding to ordinal global assessments were determined.

Results

Item-total correlations ranged from 0.27–0.67 for activity lesions present in ≥10% of patients; item-domain and domain-total correlations ranged from 0.25–0.99. Cronbach's alpha was 0.79 for the CAT activity score and 0.74 for the CAT damage score. As predicted, the CAT activity score correlated strongly with both global disease activity and skin disease activity and moderately with the Childhood Myositis Assessment Scale, whereas the CAT damage score correlated moderately with the physician global disease and skin disease damage scores. Median CAT activity scores of 1, 7, 13, 18, and 31 corresponded to absent, mild, moderate, severe, and extremely severe skin disease activity, respectively. Median CAT damage scores of 0, 1, 2, and 5 correlated with the same descriptions of damage (severe and extremely severe combined).

Conclusion

Preliminary validation of the CAT demonstrated good internal consistency, nonredundancy, good construct validity, and appropriate responsiveness. The CAT is a comprehensive, semiquantitative assessment tool for skin disease in juvenile DM.

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