title: Measurement of damage in systemic vasculitis: a comparison of the Vasculitis Damage Index with the Combined Damage Assessment Index.
abstract: OBJECTIVE
  To compare the Vasculitis Damage Index (VDI) with the Combined Damage Assessment Index (CDA) as measures of damage from vasculitis.
  
  
  METHODS
  A total of 283 patients with vasculitis from 11 European centres were evaluated in a cross-sectional study using the VDI and CDA.
  
  
  RESULTS
  Wegener's granulomatosis (58.4%) and microscopic polyangiitis (11.0%) were the most common diagnoses. Agreement between VDI and CDA scores (Spearman's correlation) was 0.90 (95% CI 0.87 to 0.92). There was good correlation between individual comparably evaluated organ systems (Spearman's correlation 0.70-0.94). Interobserver reliability (assessed by intraclass correlation coefficient (ICC)) was 0.94 (95% CI 0.89 to 0.98) for VDI and 0.78 (95% CI 0.63 to 0.93) for CDA. Intraobserver reliability was 0.92 (95% CI 0.83 to 1.00) for VDI and 0.87 (95% CI 0.75 to 1.00) for CDA. A total of 13 items were not used in the VDI compared to 23 in the CDA. Observers agreed that the CDA covered the full spectrum of damage attributable to vasculitis but was more time consuming and thus possibly less feasible for clinical and research purposes.
  
  
  CONCLUSIONS
  The VDI and CDA capture reliable data on damage among patients with vasculitis. The CDA captures more detail but is more complex and less practical than the VDI. Further evolution of damage assessment in vasculitis is likely to include key elements from both instruments.
authors.affiliation: Department of Rheumatology, Nuffield Orthopaedic Centre, Headington, Oxford, UK. ravi.suppiah@gmail.com
authors.forename: Ravi
authors.initials: R
authors.lastname: Suppiah
authors.forename: Oliver
authors.initials: O
authors.lastname: Flossman
authors.forename: Chetan
authors.initials: C
authors.lastname: Mukhtyar
authors.forename: Federico
authors.initials: F
authors.lastname: Alberici
authors.forename: Bo
authors.initials: B
authors.lastname: Baslund
authors.forename: Denise
authors.initials: D
authors.lastname: Brown
authors.forename: Nadeem
authors.initials: N
authors.lastname: Hasan
authors.forename: Julia
authors.initials: J
authors.lastname: Holle
authors.forename: Zdenka
authors.initials: Z
authors.lastname: Hruskova
authors.forename: David
authors.initials: D
authors.lastname: Jayne
authors.forename: Andrew
authors.initials: A
authors.lastname: Judge
authors.forename: Mark A
authors.initials: MA
authors.lastname: Little
authors.forename: Peter A
authors.initials: PA
authors.lastname: Merkel
authors.forename: Alessandra
authors.initials: A
authors.lastname: Palmisano
authors.forename: Philip
authors.initials: P
authors.lastname: Seo
authors.forename: Coen
authors.initials: C
authors.lastname: Stegeman
authors.forename: Vladimir
authors.initials: V
authors.lastname: Tesar
authors.forename: Augusto
authors.initials: A
authors.lastname: Vaglio
authors.forename: Kerstin
authors.initials: K
authors.lastname: Westman
authors.forename: Raashid
authors.initials: R
authors.lastname: Luqmani
mesh_terms: D004812:Epidemiologic Methods; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis; D006801:Humans; D008297:Male; D055953:Microscopic Polyangiitis / Q000175:diagnosis; D015588:Observer Variation; D011379:Prognosis; D012720:Severity of Illness Index; D056647:Systemic Vasculitis / Q000175:diagnosis*