RT Journal Article
SR Electronic
T1 Preliminary Validation of the Digital Ulcer Clinical Assessment Score in Systemic Sclerosis
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.171486
DO 10.3899/jrheum.171486
A1 Cosimo Bruni
A1 Tanaka Ngcozana
A1 Francesca Braschi
A1 Tiziana Pucci
A1 Guya Piemonte
A1 Laura Benelli
A1 Melissa Poli
A1 Yossra A.  Suliman
A1 Serena Guiducci
A1 Silvia Bellando-Randone
A1 Silvia Balduzzi
A1 Jonathan Grotts
A1 Christopher P.  Denton
A1 Laura Rasero
A1 CarloMaurizio Montecucco
A1 Daniel E.  Furst
A1 Marco Matucci-Cerinic
YR 2018
UL http://www.jrheum.org/content/early/2018/11/12/jrheum.171486.abstract
AB Objective To date, “healed/non-healed” and clinical judgment are the only available assessment tools for digital ulcers (DU) in patients with systemic sclerosis (SSc). The aim of our study is to examine a preliminary composite DU clinical assessment score (DUCAS) for SSc for face, content, and construct validity. Methods Patients with SSc presenting at least 1 finger DU were enrolled and assessed with the Health Assessment Questionnaire–Disability Index, Cochin scale, visual analog scale (VAS) for DU-related pain, patient global DU status, and global assessment as patient-reported outcomes (PRO), and physician VAS for DU status (phyGDU) as an SSc-DU expert physician/nurse measure. The DUCAS included 7 DU-related variables selected by a committee of SSc DU experts and weighted on a clinical basis. Face validity was examined by consensus and partial construct validity was tested through convergent correlation with other measures of hand function, using Spearman’s correlations. A range of patients with SSc was examined. A linear regression model with backward stepwise analysis was used to determine the relationship of individual variables with the primary clinical parameter, phyGDU. Results Forty-four patients with SSc (9 males, mean age 55 ± 15 yrs, mean disease duration 9.9 ± 5.8 yrs) were enrolled in the study. Overall DUCAS showed significant positive correlations with all abovementioned PRO (r > 0.4, p < 0.01). When all scores and scales were modeled, only DUCAS significantly predicted phyGDU (r = 0.59, R² = 0.354, Akaike information criterion = 385.4). Conclusion Preliminarily, we suggest that the DUCAS may be a new clinical score for SSc-related DU, having face and content validity and convergent/divergent correlations (construct validity). These early data suggest that this score deserves further evaluation.