THE DEVELOPMENT AND INITIAL VALIDATION OF THE SYSTEMIC LUPUS INTERNATIONAL COLLABORATING CLINICS AMERICAN-COLLEGE-OF-RHEUMATOLOGY DAMAGE INDEX FOR SYSTEMIC LUPUS-ERYTHEMATOSUS

Objective. To develop and perform an initial validation of a damage in dex for systemic lupus erythematosus (SLE). Methods. A list of items c onsidered to reflect damage in SLE was generated through a nominal gro up process. A consensus as to which items to be included in an index w as reached, together with rules for ascertainment. Each center submitt ed 2 assessments, 5 years apart, on 2 patients with active and 2 with inactive disease, of whom 1 had increased damage and the other had sta ble disease. Analysis of variance was used to test the factors physici an, time, amount of damage, and activity status. Results. Nineteen phy sicians completed the damage index on 42 case scenarios. The analysis revealed that the damage index could identify changes in damage seen i n patients with both active and inactive disease. Patients who had act ive disease at both time points had a higher increase in damage. There was good agreement among the physicians on the assessment of damage i n these patients. Conclusion. This damage index for SLE records damage occurring in patients with SLE regardless of its cause. The index was demonstrated to have content, face, criterion, and discriminant valid ity.