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Interrater reliability and aspects of validity of the myositis damage index
  1. Shabina M Sultan1,
  2. Elizabeth Allen2,
  3. Robert G Cooper3,
  4. Sangita Agarwal4,
  5. Patrick Kiely4,
  6. Chester V Oddis5,
  7. Jiri Vencovsky6,
  8. Ingrid E Lundberg7,
  9. Maryam Dastmalchi7,
  10. Michael G Hanna8,
  11. David A Isenberg1
  1. 1University College London Hospitals, London, UK
  2. 2University College London, London, UK
  3. 3Hope Hospital, Manchester, UK
  4. 4St George's Hospital, London, UK
  5. 5University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA
  6. 6Institute of Rheumatology, Prague, Czech Republic
  7. 7Rheumatology Unit, Karolinska University Hospital, Stockholm, Sweden
  8. 8Institute of Neurology, University College London, London, UK
  1. Correspondence to Dr Shabina Sultan, Airedale General Hospital, Skipton Road, Keighley, West Yorkshire BD20 6TD, UK; ssultan{at}


Objective To test the interrater reliability, internal consistency and aspects of validity of the myositis damage index (MDI) in the assessment of damage in adult patients with idiopathic inflammatory myopathy (IIM).

Methods 95 patients were assessed in six centres as part of this cross-sectional international study. Two parts of a MDI were used to assess disease damage, the MDI and the myositis damage score (MYODAM). The myositis disease activity assessment tool (MDAAT) was used to assess disease activity. Interrater reliability was assessed using intraclass correlation coefficient (ICC). Spearman's rank correlation coefficient was used to measure the convergent validity of cross-sectional scores between the two parts of the damage tool and to determine the correlation between the respective components of the damage and activity tools.

Results In general, the damage index appears to have good interrater reliability for most of the systems with an ICC greater than 0.65. Convergent validity between the two parts of the damage tool showed good correlation for the individual organ systems (r>0.8). There were weak correlations between some parts of the MDI and corresponding components of the MDAAT.

Conclusion The MDI is a comprehensive tool to assess damage in patients with myositis. With physician education and emphasis to record items that have been diagnosed since the myositis diagnosis, the MDI will provide a valuable tool to assess damage in future clinical trials and longitudinal studies.

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  • Funding The UK Myositis Support Group supported SMS for this study. JV obtained institutional support (MSM 0021620812) from the Ministry of Education, Youth and Sports. Grant support for IEL was received from the Swedish Rheumatism Association.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.