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Alternative scoring of the Cutaneous Assessment Tool in juvenile dermatomyositis: results using abbreviated formats

Adam M Huber1, Peter A Lachenbruch, Elizabeth M Dugan

  • 1Izaak Walton Killam Health Centre and Dalhousie University, Halifax, Nova Scotia, Canada. adam.huber@iwk.nshealth.ca

Arthritis and Rheumatism
|March 4, 2008
PubMed

Insights

Alternative scoring methods for the Cutaneous Assessment Tool (CAT) in juvenile dermatomyositis (DM) maintain measurement characteristics. These shorter methods, maximum and binary, offer similar reliability and validity to the original CAT, improving clinical and research utility.

Area of Science:

  • Pediatric Rheumatology
  • Dermatology
  • Clinical Assessment Tools

Background:

  • The Cutaneous Assessment Tool (CAT) is a comprehensive method for assessing skin disease in juvenile dermatomyositis (DM).
  • Evaluating the CAT's measurement characteristics with alternative scoring methods is crucial for its clinical application.
  • Shortening assessment tools can improve clinician and researcher engagement.

Purpose of the Study:

  • To evaluate alternative scoring methods (maximum and binary) for the CAT in juvenile DM.
  • To determine if these abbreviated methods compromise the CAT's measurement properties.
  • To assess the reliability, validity, and responsiveness of modified CAT scoring.

Main Methods:

  • 113 children with juvenile DM were assessed at baseline, with 94 reassessed after 7-9 months.
  • Interrater reliability, internal consistency, construct validity, and responsiveness were compared across original, maximum, and binary CAT scoring methods.
  • Spearman correlations were used to compare scoring methods with each other and with other myositis disease activity measures.

Main Results:

  • The maximum and binary CAT scoring methods showed high correlations (0.96-0.98) with the original method for both activity and damage scores.
  • All three scoring methods demonstrated similar interrater reliability, internal consistency, construct validity, and responsiveness.
  • No statistically significant differences were found between the scoring methods, despite a trend towards higher interrater reliability for the maximum method and higher responsiveness for the binary method.

Conclusions:

  • The maximum and binary scoring methods for the CAT exhibit comparable measurement characteristics to the original method.
  • Adopting these abbreviated scoring methods is recommended to enhance the CAT's clinical and research acceptability.
  • These findings support the use of simplified CAT scoring for efficient juvenile DM assessment.
Abstract

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