title: International consensus outcome measures for patients with idiopathic inflammatory myopathies. Development and initial validation of myositis activity and damage indices in patients with adult onset disease.
abstract: OBJECTIVE
  To devise new tools to assess activity and damage in patients with idiopathic myopathies (IIM).
  
  
  METHODS
  An international multidisciplinary consensus effort to standardize the conduct and reporting of the myositis clinical trials has been established. Two tools, known as the myositis intention to treat index (MITAX) and the myositis disease activity assessment visual analogue scale (MYOACT), have been developed to capture activity in patients with IIM. In addition, the myositis damage index (MDI) has been devised to assess the extent and severity of damage developing in different organs and systems. These measures have been reviewed by the myositis experts participating in the International Myositis Assessment and Clinical Studies (IMACS) group and have been found to have good face validity and to be comprehensive. The instruments were assessed in two real patient exercises involving patients with adult dermatomyositis and inclusion body myositis.
  
  
  RESULTS
  The reliability of MITAX, MYOACT and MDI, measured by the intraclass correlation coefficient among the physicians, and the inter-rater reliability, as assessed by variation in the physicians' rating of patients, was fair to good for most aspects of the tools. Reliability and inter-rater agreement improved at the second exercise after the participants had completed additional training.
  
  
  CONCLUSIONS
  The MITAX, MYOACT and MDI tools, which are now undergoing validity testing, should enhance the consistency, comprehensiveness and reliability of disease activity and damage assessment in patients with myositis.
authors.affiliation: Center for Rheumatology, Department of Medicine, The Middlesex Hospital, University College London, London, UK. d.isenberg@ucl.ac.uk
authors.forename: D A
authors.initials: DA
authors.lastname: Isenberg
authors.forename: E
authors.initials: E
authors.lastname: Allen
authors.forename: V
authors.initials: V
authors.lastname: Farewell
authors.forename: M R
authors.initials: MR
authors.lastname: Ehrenstein
authors.forename: M G
authors.initials: MG
authors.lastname: Hanna
authors.forename: I E
authors.initials: IE
authors.lastname: Lundberg
authors.forename: C
authors.initials: C
authors.lastname: Oddis
authors.forename: C
authors.initials: C
authors.lastname: Pilkington
authors.forename: P
authors.initials: P
authors.lastname: Plotz
authors.forename: D
authors.initials: D
authors.lastname: Scott
authors.forename: J
authors.initials: J
authors.lastname: Vencovsky
authors.forename: R
authors.initials: R
authors.lastname: Cooper
authors.forename: L
authors.initials: L
authors.lastname: Rider
authors.forename: F
authors.initials: F
authors.lastname: Miller
mesh_terms: D000208:Acute Disease; D000704:Analysis of Variance; D005080:Exercise Test; D006801:Humans; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009220:Myositis / Q000175:diagnosis* / Q000276:immunology*; D015203:Reproducibility of Results