Evaluation of the reliability and validity of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) in paediatric cutaneous lupus among paediatric dermatologists and rheumatologists

C. J. Kushner, M. Tarazi, R. G. Gaffney, R. Feng, K. Ardalan, H. A. Brandling-Bennett, L. Castelo-Soccio, J. C. Chang, Y. E. Chiu, S. Gmuca, R. D. Hunt, P. J. Kahn, A. M. Knight, J. Mehta, D. R. Pearson, J. R. Treat, J. Wan, A. C. Yeguez, J. S.S. Concha, B. PatelJ. Okawa, L. M. Arkin, V. P. Werth

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background: The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is a reliable outcome measure for cutaneous lupus erythematosus (CLE) in adults used in clinical trials. However, it has not been validated in children, limiting clinical trials for paediatric CLE. Objectives: This study aimed to validate the CLASI in paediatrics. Methods: Eleven paediatric patients with CLE, six dermatologists and six rheumatologists participated. The physicians were trained to use the CLASI and Physician's Global Assessment (PGA), and individually rated all patients using both tools. Each physician reassessed two randomly selected patients. Within each physician group, the intraclass correlation coefficient (ICC) was calculated to assess the reliability of each measure. Results: CLASI activity scores demonstrated excellent inter- and intrarater reliability (ICC > 0·90), while the PGA activity scores had good inter-rater reliability (ICC 0·73–0·77) among both specialties. PGA activity scores showed excellent (ICC 0·89) and good intrarater reliability (ICC 0·76) for dermatologists and rheumatologists, respectively. Limitations of this study include the small sample size of patients and potential recall bias during the physician rerating session. Conclusions: CLASI activity measurement showed excellent inter- and intrarater reliability in paediatric CLE and superiority over the PGA. These results demonstrate that the CLASI is a reliable and valid outcome instrument for paediatric CLE.

Original languageEnglish (US)
Pages (from-to)165-171
Number of pages7
JournalBritish Journal of Dermatology
Volume180
Issue number1
DOIs
StatePublished - Jan 2019

Bibliographical note

Funding Information:
This work was funded by a Childhood Arthritis and Rheumatology Research Alliance Arthritis Foundation grant, by the Lupus Foundation of America Philadelphia Tri-State Chapter and by the Department of Veterans Affairs (Veterans Health Administration).

Funding Information:
We would like to acknowledge all of the patients and their families who travelled near and far to attend our study day. We would like to thank Julie Burroughs for her administrative support and facilitation during the study day. We also thank the following physicians for their assistance in recruiting patients: Donald Goldsmith, MD, and Svetlana Lvovich, DO, of St Christopher's Hospital for Children, Philadelphia, PA, U.S.A.; Lisabeth Scalzi, MD, MS, of Penn State Children's Hospital, Hershey, PA, U.S.A.; Megan L. Curran, MD, and Marisa Klein-Gitelman MD, MPH, of Northwestern University Feinberg School of Medicine, Chicago, IL, U.S.A.; A. Yasmine Kirkorian, MD, of the Children's National Medical Center, Washington, DC, U.S.A.; and Sarah Sertial, DO, of Penn State Health Milton S. Hershey Medical Center, Hershey, PA, U.S.A. We also wish to acknowledge the assistance of the Lupus Foundation of America for assistance in recruiting patients. Finally, we would like to thank the Childhood Arthritis and Rheumatology Research Alliance (CARRA) group; the Lupus Foundation of America (Philadelphia Tri-State Chapter) and the Department of Veterans Affairs (Veterans Health Administration), Office of Research and Development, Biomedical Laboratory Research and Development (V.P.W.), for funding this research.

Funding Information:
We would like to acknowledge all of the patients and their families who travelled near and far to attend our study day. We would like to thank Julie Burroughs for her administrative support and facilitation during the study day. We also thank the following physicians for their assistance in recruiting patients: Donald Goldsmith, MD, and Svetlana Lvovich, DO, of St Christopher’s Hospital for Children, Philadelphia, PA, U.S.A.; Lisabeth Scalzi, MD, MS, of Penn State Children’s Hospital, Hershey, PA, U.S.A.; Megan L. Curran, MD, and Marisa Klein-Gitelman MD, MPH, of Northwestern University Feinberg School of Medicine, Chicago, IL, U.S.A.; A. Yasmine Kirkorian, MD, of the Children’s National Medical Center, Washington, DC, U.S.A.; and Sarah Sertial, DO, of Penn State Health Milton S. Hershey Medical Center, Hershey, PA, U.S.A. We also wish to acknowledge the assistance of the Lupus Foundation of America for assistance in recruiting patients. Finally, we would like to thank the Childhood Arthritis and Rheumatology Research Alliance (CARRA) group; the Lupus Foundation of America (Philadelphia Tri-State Chapter) and the Department of Veterans Affairs (Veterans Health Administration), Office of Research and Development, Biomedical Laboratory Research and Development (V.P.W.), for funding this research.

Publisher Copyright:
© 2018 British Association of Dermatologists

Fingerprint

Dive into the research topics of 'Evaluation of the reliability and validity of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) in paediatric cutaneous lupus among paediatric dermatologists and rheumatologists'. Together they form a unique fingerprint.

Cite this