PT  - JOURNAL ARTICLE
AU  - Philip Seo
AU  - Raashid A Luqmani
AU  - Oliver Flossmann
AU  - Bernhard Hellmich
AU  - Karen Herlyn
AU  - Gary S Hoffman
AU  - David Jayne
AU  - Cees G M Kallenberg
AU  - Carol A Langford
AU  - Alfred Mahr
AU  - Eric L Matteson
AU  - Chetan B Mukhtyar
AU  - Tuhina Neogi
AU  - Abraham Rutgers
AU  - Ulrich Specks
AU  - John H Stone
AU  - Steven R Ytterberg
AU  - Peter A Merkel
TI  - The future of damage assessment in vasculitis.
DP  - 2007 Jun 01
TA  - The Journal of Rheumatology
PG  - 1357--1371
VI  - 34
IP  - 6
4099  - http://www.jrheum.org/content/34/6/1357.short
4100  - http://www.jrheum.org/content/34/6/1357.full
SO  - J Rheumatol2007 Jun 01; 34
AB  - Damage denotes the aspects of chronic disease that do not reverse with therapy. This concept is particularly important for the primary systemic vasculitides, since the careful differentiation between activity and damage may help avoid unnecessary exposure to cytotoxic medications. Damage significantly influences both longterm prognosis and quality of life. Because the primary systemic vasculitides have diverse manifestations, the use of a damage assessment instrument is crucial to ensure reproducibility. The Vasculitis Damage Index (VDI) is the only validated measure for damage assessment in vasculitis. Use of the VDI in recent clinical trials has shown that it may not adequately determine the full spectrum of damage experienced by patients with vasculitis of small- and medium-size vessels. We propose reexamining the way in which damage is assessed, focusing on vasculitides of small- and medium-size vessels, and outline an initiative to create a substantially revised and improved damage assessment instrument using data-driven approaches. This initiative is part of a larger international effort to create a unified approach to disease assessment for the primary systemic vasculitides.