title: The CLASI (Cutaneous Lupus Erythematosus Disease Area and Severity Index): an outcome instrument for cutaneous lupus erythematosus.
abstract: We developed and validated a measurement instrument (CLASI-Cutaneous Lupus Erythematosus Disease Area and Severity Index) for lupus erythematosus that could be used in clinical trials. The instrument has separate scores for damage and activity. A group of seven American Dermato-Rheumatologists and the "American College of Rheumatology Response Criteria Committee on SLE (systemic lupus erythematosus)" assessed content validity. After a preliminary session, we conducted standardized interviews with the raters and made slight changes to the instrument. The final instrument was evaluated by five dermatologists and six residents who scored nine patients to estimate inter- and intra-rater reliability in two sessions. Consultation with experts has established content validity of the instrument. Reliability studies demonstrated an intra-class correlation coefficient (ICC) for inter-rater reliability of 0.86 for the activity score (95% confidence interval (CI) = 0.73-0.99) and of 0.92 for the damage score (95% CI = 0.85-1.00). The Spearman's rho (Sp) for intra-rater reliability for the activity score was 0.96 (95% CI = 0.89 to 1.00) and for the damage score Sp was 0.99 (95% CI = 0.97-1.00). Clinical responsiveness needs to be evaluated in a prospective clinical trial, which is ongoing.
authors.affiliation: Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Joerg
authors.initials: J
authors.lastname: Albrecht
authors.forename: Lynne
authors.initials: L
authors.lastname: Taylor
authors.forename: Jesse A
authors.initials: JA
authors.lastname: Berlin
authors.forename: Samuel
authors.initials: S
authors.lastname: Dulay
authors.forename: Gina
authors.initials: G
authors.lastname: Ang
authors.forename: Steven
authors.initials: S
authors.lastname: Fakharzadeh
authors.forename: Jonathan
authors.initials: J
authors.lastname: Kantor
authors.forename: Ellen
authors.initials: E
authors.lastname: Kim
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Militello
authors.forename: Karen
authors.initials: K
authors.lastname: McGinnis
authors.forename: Stephen
authors.initials: S
authors.lastname: Richardson
authors.forename: James
authors.initials: J
authors.lastname: Treat
authors.forename: Carmela
authors.initials: C
authors.lastname: Vittorio
authors.forename: Abby
authors.initials: A
authors.lastname: Van Voorhees
authors.forename: Victoria P
authors.initials: VP
authors.lastname: Werth
mesh_terms: D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000175:diagnosis*; D011379:Prognosis; D012720:Severity of Illness Index