Validation and clinical significance of the Childhood Myositis Assessment Scale for assessment of muscle function in the juvenile idiopathic inflammatory myopathies

Huber, Adam M.; Feldman, Brian M.; Rennebohm, Robert M.; Hicks, Jeanne E.; Lindsley, Carol B.; Perez, Maria D.; Zemel, Lawrence; Wallace, Carol A.; Ballinger, Susan H.; Passo, Murray H.; Reed, Ann M.; Summers, Ronald M.; White, Patience H.; Katona, Ildy M.; Miller, Frederick W.; Lachenbruch, Peter A.; Rider, Lisa G.

doi:10.1002/art.20179

Cited by 186 publications

(133 citation statements)

References 15 publications

(24 reference statements)

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“…We have previously demonstrated that global skin disease activity correlates moderately with measures of physical function in children with juvenile DM (4,5). In adults with DM, Hundley et al have demonstrated that active skin disease is associated with reduced quality of life (6).…”

Section: Introductionmentioning

confidence: 91%

Preliminary validation and clinical meaning of the cutaneous assessment tool in juvenile dermatomyositis

Huber

Dugan

Lachenbruch

et al. 2008

Arthritis & Rheumatism

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Objective. To provide preliminary validation of the Cutaneous Assessment Tool (CAT), a new tool to assess cutaneous manifestations of juvenile dermatomyositis (DM), and to explore the clinical meaning of CAT scores. Methods. Children with juvenile DM (n ‫؍‬ 113) were assessed at baseline and 7-9 months later (n ‫؍‬ 94). Internal consistency, redundancy, construct validity, and responsiveness of the CAT were examined. CAT scores corresponding to ordinal global assessments were determined. Results. Item-total correlations ranged from 0.27-0.67 for activity lesions present in >10% of patients; item-domain and domain-total correlations ranged from 0.25-0.99. Cronbach's alpha was 0.79 for the CAT activity score and 0.74 for the CAT damage score. As predicted, the CAT activity score correlated strongly with both global disease activity and skin disease activity and moderately with the Childhood Myositis Assessment Scale, whereas the CAT damage score correlated moderately with the physician global disease and skin disease damage scores. Median CAT activity scores of 1, 7, 13, 18, and 31 corresponded to absent, mild, moderate, severe, and extremely severe skin disease activity, respectively. Median CAT damage scores of 0, 1, 2, and 5 correlated with the same descriptions of damage (severe and extremely severe combined). Conclusion. Preliminary validation of the CAT demonstrated good internal consistency, nonredundancy, good construct validity, and appropriate responsiveness. The CAT is a comprehensive, semiquantitative assessment tool for skin disease in juvenile DM.

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Section: Introductionmentioning

confidence: 91%

Preliminary validation and clinical meaning of the cutaneous assessment tool in juvenile dermatomyositis

Huber

Dugan

Lachenbruch

et al. 2008

Arthritis & Rheumatism

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Section: Patientsmentioning

confidence: 99%

“…Physician and parent global assessments of disease activity and damage, using both Likert and VAS scales, were obtained (2,5). The Physician Global Disease Activity and Damage VAS score is an accepted standardized scoring system for assessing disease activity and damage (2,5). Twenty-two patients (at one center) Ͼ4 years of age underwent manual muscle testing, which was performed by a pediatric physical therapist; this could not be performed in younger patients, as previously explained by Rider (6).…”

Section: Patientsmentioning

confidence: 99%

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Muscle metabolites, detected in urine by proton spectroscopy, correlate with disease damage in juvenile idiopathic inflammatory myopathies

et al. 2005

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Objective. To assess for novel markers of muscle damage using urinary muscle metabolites by 1 H magnetic resonance spectroscopy in patients with juvenile idiopathic inflammatory myopathy (IIM). Methods. Creatine (Cr), choline (Cho), betaine (Bet), glycine (Gly), trimethylamine oxide (TMAO), and several other metabolites were measured in first morning void urine samples from 45 patients with juvenile IIM and from 35 healthy age-matched controls, and correlated with measures of myositis disease activity and damage. Urinary metabolite to age-adjusted creatinine (Cn) ratios were examined. Results. Age-adjusted initial

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“…Formal measures such as the Childhood Myositis Assessment Scale (CMAS) 6 and manual muscle testing of 8 groups (MMT8) 7 exist to standardize the muscle assessment. Both are part of the agreed Juvenile Dermatomyositis Paediatric Rheumatology International Trials Organisation 8 and International Myositis Assessment and Clinical Studies Group 9 core disease activity measures.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Utility and Validity of Three Scoring Tools to Measure Skin Involvement in Patients With Juvenile Dermatomyositis

Campanilho-Marques

Almeida

Deakin

et al. 2016

Arthritis Care & Research

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ObjectiveTo compare the abbreviated Cutaneous Assessment Tool (CAT), Disease Activity Score (DAS), and Myositis Intention to Treat Activity Index (MITAX) and correlate them with the physician's 10‐cm skin visual analog scale (VAS) in order to define which tool best assesses skin disease in patients with juvenile dermatomyositis.MethodsA total of 71 patients recruited to the UK Juvenile Dermatomyositis Cohort and Biomarker Study were included and assessed for skin disease using the CAT, DAS, MITAX, and skin VAS. The Childhood Myositis Assessment Scale (CMAS), manual muscle testing of 8 groups (MMT8), muscle enzymes, inflammatory markers, and physician's global VAS were recorded. Relationships were evaluated using Spearman's correlations and predictors with linear regression. Interrater reliability was assessed using intraclass correlation coefficients.ResultsAll 3 tools showed correlation with the physician's global VAS and skin VAS, with DAS skin showing the strongest correlation with skin VAS. DAS skin and CAT activity were inversely correlated with CMAS and MMT8, but these correlations were moderate. No correlations were found between the skin tools and inflammatory markers or muscle enzymes. DAS skin and CAT were the quickest to complete (mean ± SD 0.68 ± 0.1 minutes and 0.63 ± 0.1 minutes, respectively).ConclusionThe 3 skin tools were quick and easy to use. The DAS skin correlated best with the skin VAS. The addition of CAT in a bivariate model containing the physician's global VAS was a statistically significant estimator of skin VAS score. We propose that there is scope for a new skin tool to be devised and tested, which takes into account the strengths of the 3 existing tools.

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Validation and clinical significance of the Childhood Myositis Assessment Scale for assessment of muscle function in the juvenile idiopathic inflammatory myopathies

Cited by 186 publications

References 15 publications

Preliminary validation and clinical meaning of the cutaneous assessment tool in juvenile dermatomyositis

Preliminary validation and clinical meaning of the cutaneous assessment tool in juvenile dermatomyositis

Muscle metabolites, detected in urine by proton spectroscopy, correlate with disease damage in juvenile idiopathic inflammatory myopathies

Comparison of the Utility and Validity of Three Scoring Tools to Measure Skin Involvement in Patients With Juvenile Dermatomyositis

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