Preliminary Validation of the Digital Ulcer Clinical Assessment Score in Systemic Sclerosis

Cosimo Bruni, Tanaka Ngcozana, Francesca Braschi, Tiziana Pucci, Guya Piemonte, Laura Benelli, Melissa Poli, Yossra A Suliman, Serena Guiducci, Silvia Bellando-Randone, Silvia Balduzzi, Jonathan Grotts, Christopher P Denton, Laura Rasero, CarloMaurizio Montecucco, Daniel E Furst, Marco Matucci-Cerinic

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
JournalJournal of Rheumatology
DOIs
Publication statusE-pub ahead of print - Nov 15 2018

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Systemic Scleroderma
Ulcer
Visual Analog Scale
Reproducibility of Results
Linear Models
Physicians
Fingers
Consensus
Hand
Nurses
Pain

Cite this

Bruni, C., Ngcozana, T., Braschi, F., Pucci, T., Piemonte, G., Benelli, L., ... Matucci-Cerinic, M. (2018). Preliminary Validation of the Digital Ulcer Clinical Assessment Score in Systemic Sclerosis. Journal of Rheumatology. https://doi.org/10.3899/jrheum.171486

Preliminary Validation of the Digital Ulcer Clinical Assessment Score in Systemic Sclerosis. / Bruni, Cosimo; Ngcozana, Tanaka; Braschi, Francesca; Pucci, Tiziana; Piemonte, Guya; Benelli, Laura; Poli, Melissa; Suliman, Yossra A; Guiducci, Serena; Bellando-Randone, Silvia; Balduzzi, Silvia; Grotts, Jonathan; Denton, Christopher P; Rasero, Laura; Montecucco, CarloMaurizio; Furst, Daniel E; Matucci-Cerinic, Marco.

In: Journal of Rheumatology, 15.11.2018.

Research output: Contribution to journalArticle

Bruni, C, Ngcozana, T, Braschi, F, Pucci, T, Piemonte, G, Benelli, L, Poli, M, Suliman, YA, Guiducci, S, Bellando-Randone, S, Balduzzi, S, Grotts, J, Denton, CP, Rasero, L, Montecucco, C, Furst, DE & Matucci-Cerinic, M 2018, 'Preliminary Validation of the Digital Ulcer Clinical Assessment Score in Systemic Sclerosis', Journal of Rheumatology. https://doi.org/10.3899/jrheum.171486
Bruni, Cosimo ; Ngcozana, Tanaka ; Braschi, Francesca ; Pucci, Tiziana ; Piemonte, Guya ; Benelli, Laura ; Poli, Melissa ; Suliman, Yossra A ; Guiducci, Serena ; Bellando-Randone, Silvia ; Balduzzi, Silvia ; Grotts, Jonathan ; Denton, Christopher P ; Rasero, Laura ; Montecucco, CarloMaurizio ; Furst, Daniel E ; Matucci-Cerinic, Marco. / Preliminary Validation of the Digital Ulcer Clinical Assessment Score in Systemic Sclerosis. In: Journal of Rheumatology. 2018.
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title = "Preliminary Validation of the Digital Ulcer Clinical Assessment Score in Systemic Sclerosis",
abstract = "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.",
author = "Cosimo Bruni and Tanaka Ngcozana and Francesca Braschi and Tiziana Pucci and Guya Piemonte and Laura Benelli and Melissa Poli and Suliman, {Yossra A} and Serena Guiducci and Silvia Bellando-Randone and Silvia Balduzzi and Jonathan Grotts and Denton, {Christopher P} and Laura Rasero and CarloMaurizio Montecucco and Furst, {Daniel E} and Marco Matucci-Cerinic",
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T1 - Preliminary Validation of the Digital Ulcer Clinical Assessment Score in Systemic Sclerosis

AU - Bruni, Cosimo

AU - Ngcozana, Tanaka

AU - Braschi, Francesca

AU - Pucci, Tiziana

AU - Piemonte, Guya

AU - Benelli, Laura

AU - Poli, Melissa

AU - Suliman, Yossra A

AU - Guiducci, Serena

AU - Bellando-Randone, Silvia

AU - Balduzzi, Silvia

AU - Grotts, Jonathan

AU - Denton, Christopher P

AU - Rasero, Laura

AU - Montecucco, CarloMaurizio

AU - Furst, Daniel E

AU - Matucci-Cerinic, Marco

PY - 2018/11/15

Y1 - 2018/11/15

N2 - 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.

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.

U2 - 10.3899/jrheum.171486

DO - 10.3899/jrheum.171486

M3 - Article

C2 - 30442833

JO - Journal of Rheumatology

JF - Journal of Rheumatology

SN - 0315-162X

ER -