title: Development and validation of the Canine Atopic Dermatitis Lesion Index, a scale for the rapid scoring of lesion severity in canine atopic dermatitis.
abstract: BACKGROUND
  The third iteration of the Canine Atopic Dermatitis Extent and Severity Index (CADESI-03) is the only tool rigorously validated for canine atopic dermatitis (CAD) lesion scoring. The CADESI-03 requires 248 evaluations, limiting its widespread use.
  
  
  OBJECTIVE
  The goal of the study was to develop and validate a practical method of grading CAD lesions that requires scoring only the frequently affected body regions.
  
  
  METHODS
  Fifty-seven privately owned atopic dogs were used in the study.
  
  
  METHODS
  The Canine Atopic Dermatitis Lesion Index (CADLI) was evaluated in an open, multicentre reliability study. Validity was assessed with expert opinion (content validity) and comparison of CADLI with existing disease severity measures (construct and criterion validity). Reliability was evaluated by analysing repeated observations of each dog. Convenience was assessed in terms of the time required to complete the scale.
  
  
  RESULTS
  The CADLI scores correlated with overall assessment scores (r = 0.60, P < 0.001, linear mixed model) and pruritus severity scores (r = 0.53, P < 0.001, linear mixed model), establishing construct validity. The CADLI was strongly correlated with CADESI-03 (r = 0.84, P < 0.001, linear mixed model), establishing criterion validity. The CADLI values obtained by two observers correlated very strongly (r = 0.91, P < 0.001), as did the repeat values for the same observer (r = 0.98, P < 0.001). The mean time to complete the CADLI was less than that required for CADESI-03 (1.9 and 12.6 min, respectively), a highly significant difference (P < 0.001).
  
  
  CONCLUSIONS
  The CADLI was found to be an effective measure of CAD lesion severity, strongly correlating with CADESI-03. The convenience of CADLI makes it suitable for use in both clinical research and practice.
authors.affiliation: SkinVet Clinic, Lake Oswego, OR 97035, USA. jon.plant@skinvetclinic.com
authors.forename: Jon D
authors.initials: JD
authors.lastname: Plant
authors.forename: Kinga
authors.initials: K
authors.lastname: Gortel
authors.forename: Marcel
authors.initials: M
authors.lastname: Kovalik
authors.forename: Nayak L
authors.initials: NL
authors.lastname: Polissar
authors.forename: Moni B
authors.initials: MB
authors.lastname: Neradilek
mesh_terms: D000818:Animals; D003876:Dermatitis, Atopic / Q000473:pathology / Q000662:veterinary*; D004283:Dog Diseases / Q000145:classification* / Q000473:pathology*; D004285:Dogs; D010147:Pain Measurement / Q000145:classification / Q000662:veterinary*; D011537:Pruritus / Q000145:classification / Q000662:veterinary*; D015203:Reproducibility of Results; D012720:Severity of Illness Index