title: The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus.
abstract: OBJECTIVE
  To develop and perform an initial validation of a damage index for systemic lupus erythematosus (SLE).
  
  
  METHODS
  A list of items considered to reflect damage in SLE was generated through a nominal group process. A consensus as to which items to be included in an index was reached, together with rules for ascertainment. Each center submitted 2 assessments, 5 years apart, on 2 patients with active and 2 with inactive disease, of whom 1 had increased damage and the other had stable disease. Analysis of variance was used to test the factors physician, time, amount of damage, and activity status.
  
  
  RESULTS
  Nineteen physicians completed the damage index on 42 case scenarios. The analysis revealed that the damage index could identify changes in damage seen in patients with both active and inactive disease. Patients who had active disease at both time points had a higher increase in damage. There was good agreement among the physicians on the assessment of damage in these patients.
  
  
  CONCLUSIONS
  This damage index for SLE records damage occurring in patients with SLE regardless of its cause. The index was demonstrated to have content, face, criterion, and discriminant validity.
authors.affiliation: The Toronto Hospital, Ontario, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Gladman
authors.forename: E
authors.initials: E
authors.lastname: Ginzler
authors.forename: C
authors.initials: C
authors.lastname: Goldsmith
authors.forename: P
authors.initials: P
authors.lastname: Fortin
authors.forename: M
authors.initials: M
authors.lastname: Liang
authors.forename: M
authors.initials: M
authors.lastname: Urowitz
authors.forename: P
authors.initials: P
authors.lastname: Bacon
authors.forename: S
authors.initials: S
authors.lastname: Bombardieri
authors.forename: J
authors.initials: J
authors.lastname: Hanly
authors.forename: E
authors.initials: E
authors.lastname: Hay
authors.forename: D
authors.initials: D
authors.lastname: Isenberg
authors.forename: J
authors.initials: J
authors.lastname: Jones
authors.forename: K
authors.initials: K
authors.lastname: Kalunian
authors.forename: P
authors.initials: P
authors.lastname: Maddison
authors.forename: O
authors.initials: O
authors.lastname: Nived
authors.forename: M
authors.initials: M
authors.lastname: Petri
authors.forename: M
authors.initials: M
authors.lastname: Richter
authors.forename: J
authors.initials: J
authors.lastname: Sanchez-Guerrero
authors.forename: M
authors.initials: M
authors.lastname: Snaith
authors.forename: G
authors.initials: G
authors.lastname: Sturfelt
authors.forename: D
authors.initials: D
authors.lastname: Symmons
authors.forename: A
authors.initials: A
authors.lastname: Zoma
mesh_terms: D006305:Health Status Indicators; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000473:pathology; D015203:Reproducibility of Results; D012216:Rheumatic Diseases / Q000175:diagnosis* / Q000473:pathology