Inter and intraobserver variability of total skin thickness score (Modified Rodnan TSS) in systemic sclerosis

P. Clements, P. Lachenbruch, J. Siebold, B. White, S. Weiner, R. Martin, A. Weinstein, M. Weisman, M. Mayes, D. Collier, Fredrick Wigley, T. Medsger, V. Steen, L. Moreland, M. Dixon, M. Massa, E. Lally, D. McCloskey, J. Varga

Research output: Contribution to journalArticle

Abstract

Objective. Assessment of the inter and intraobserver variability of the modified Rodnan (m-Rodnan) total skin thickness score by clinical palpation [a commonly used outcome measure in trials of systemic sclerosis (SSc)]. Methods. Skin thickness was assessed by clinical palpation of 17 body areas on a 0 to 3 scale (normal, mild, moderate, severe). The m-Rodnan total skin thickness score was derived by summation of the scores from all 17 body areas. Using the m-Rodnan, 6-7 investigators assessed skin thickness in 5-6 patients with SSc (22 patients and 23 examiners total) at each of 4 sessions for the determination of interobserver variability (accuracy). In addition 21 of the investigators then assessed m-Rodnan in 2-3 patients each (60 patients total) 3 times over a 2-8 week period to quantitate intraobserver variability (reliability). Results. Interobserver and intraobserver mean ± within patient standard deviations (SD) for the m-Rodnan were found to be 17.7 ± 4.6 and 20.7 ± 2.45, respectively. Conclusion. The m-Rodnan total skin thickness score is at least as reliable for measuring skin thickness in SSc as are the ARA and Ritchie joint tenderness counts for assessing joint disease in rheumatoid arthritis. These data are useful for the determination of sample size and for the definitions of clinically meaningful response. Assessment of skin score is sufficiently reproducible to include as a measure of disease outcome, especially if patients are serially evaluated by the same investigator.

Original languageEnglish (US)
Pages (from-to)1281-1285
Number of pages5
JournalJournal of Rheumatology
Volume22
Issue number7
StatePublished - 1995
Externally publishedYes

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Observer Variation
Systemic Scleroderma
Skin
Palpation
Research Personnel
Outcome Assessment (Health Care)
Joint Diseases
Sample Size
Rheumatoid Arthritis
Joints

Keywords

  • Scleroderma
  • Skin score
  • Skin thickness
  • Systemic sclerosis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Cite this

Clements, P., Lachenbruch, P., Siebold, J., White, B., Weiner, S., Martin, R., ... Varga, J. (1995). Inter and intraobserver variability of total skin thickness score (Modified Rodnan TSS) in systemic sclerosis. Journal of Rheumatology, 22(7), 1281-1285.

Inter and intraobserver variability of total skin thickness score (Modified Rodnan TSS) in systemic sclerosis. / Clements, P.; Lachenbruch, P.; Siebold, J.; White, B.; Weiner, S.; Martin, R.; Weinstein, A.; Weisman, M.; Mayes, M.; Collier, D.; Wigley, Fredrick; Medsger, T.; Steen, V.; Moreland, L.; Dixon, M.; Massa, M.; Lally, E.; McCloskey, D.; Varga, J.

In: Journal of Rheumatology, Vol. 22, No. 7, 1995, p. 1281-1285.

Research output: Contribution to journalArticle

Clements, P, Lachenbruch, P, Siebold, J, White, B, Weiner, S, Martin, R, Weinstein, A, Weisman, M, Mayes, M, Collier, D, Wigley, F, Medsger, T, Steen, V, Moreland, L, Dixon, M, Massa, M, Lally, E, McCloskey, D & Varga, J 1995, 'Inter and intraobserver variability of total skin thickness score (Modified Rodnan TSS) in systemic sclerosis', Journal of Rheumatology, vol. 22, no. 7, pp. 1281-1285.
Clements P, Lachenbruch P, Siebold J, White B, Weiner S, Martin R et al. Inter and intraobserver variability of total skin thickness score (Modified Rodnan TSS) in systemic sclerosis. Journal of Rheumatology. 1995;22(7):1281-1285.
Clements, P. ; Lachenbruch, P. ; Siebold, J. ; White, B. ; Weiner, S. ; Martin, R. ; Weinstein, A. ; Weisman, M. ; Mayes, M. ; Collier, D. ; Wigley, Fredrick ; Medsger, T. ; Steen, V. ; Moreland, L. ; Dixon, M. ; Massa, M. ; Lally, E. ; McCloskey, D. ; Varga, J. / Inter and intraobserver variability of total skin thickness score (Modified Rodnan TSS) in systemic sclerosis. In: Journal of Rheumatology. 1995 ; Vol. 22, No. 7. pp. 1281-1285.
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abstract = "Objective. Assessment of the inter and intraobserver variability of the modified Rodnan (m-Rodnan) total skin thickness score by clinical palpation [a commonly used outcome measure in trials of systemic sclerosis (SSc)]. Methods. Skin thickness was assessed by clinical palpation of 17 body areas on a 0 to 3 scale (normal, mild, moderate, severe). The m-Rodnan total skin thickness score was derived by summation of the scores from all 17 body areas. Using the m-Rodnan, 6-7 investigators assessed skin thickness in 5-6 patients with SSc (22 patients and 23 examiners total) at each of 4 sessions for the determination of interobserver variability (accuracy). In addition 21 of the investigators then assessed m-Rodnan in 2-3 patients each (60 patients total) 3 times over a 2-8 week period to quantitate intraobserver variability (reliability). Results. Interobserver and intraobserver mean ± within patient standard deviations (SD) for the m-Rodnan were found to be 17.7 ± 4.6 and 20.7 ± 2.45, respectively. Conclusion. The m-Rodnan total skin thickness score is at least as reliable for measuring skin thickness in SSc as are the ARA and Ritchie joint tenderness counts for assessing joint disease in rheumatoid arthritis. These data are useful for the determination of sample size and for the definitions of clinically meaningful response. Assessment of skin score is sufficiently reproducible to include as a measure of disease outcome, especially if patients are serially evaluated by the same investigator.",
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T1 - Inter and intraobserver variability of total skin thickness score (Modified Rodnan TSS) in systemic sclerosis

AU - Clements, P.

AU - Lachenbruch, P.

AU - Siebold, J.

AU - White, B.

AU - Weiner, S.

AU - Martin, R.

AU - Weinstein, A.

AU - Weisman, M.

AU - Mayes, M.

AU - Collier, D.

AU - Wigley, Fredrick

AU - Medsger, T.

AU - Steen, V.

AU - Moreland, L.

AU - Dixon, M.

AU - Massa, M.

AU - Lally, E.

AU - McCloskey, D.

AU - Varga, J.

PY - 1995

Y1 - 1995

N2 - Objective. Assessment of the inter and intraobserver variability of the modified Rodnan (m-Rodnan) total skin thickness score by clinical palpation [a commonly used outcome measure in trials of systemic sclerosis (SSc)]. Methods. Skin thickness was assessed by clinical palpation of 17 body areas on a 0 to 3 scale (normal, mild, moderate, severe). The m-Rodnan total skin thickness score was derived by summation of the scores from all 17 body areas. Using the m-Rodnan, 6-7 investigators assessed skin thickness in 5-6 patients with SSc (22 patients and 23 examiners total) at each of 4 sessions for the determination of interobserver variability (accuracy). In addition 21 of the investigators then assessed m-Rodnan in 2-3 patients each (60 patients total) 3 times over a 2-8 week period to quantitate intraobserver variability (reliability). Results. Interobserver and intraobserver mean ± within patient standard deviations (SD) for the m-Rodnan were found to be 17.7 ± 4.6 and 20.7 ± 2.45, respectively. Conclusion. The m-Rodnan total skin thickness score is at least as reliable for measuring skin thickness in SSc as are the ARA and Ritchie joint tenderness counts for assessing joint disease in rheumatoid arthritis. These data are useful for the determination of sample size and for the definitions of clinically meaningful response. Assessment of skin score is sufficiently reproducible to include as a measure of disease outcome, especially if patients are serially evaluated by the same investigator.

AB - Objective. Assessment of the inter and intraobserver variability of the modified Rodnan (m-Rodnan) total skin thickness score by clinical palpation [a commonly used outcome measure in trials of systemic sclerosis (SSc)]. Methods. Skin thickness was assessed by clinical palpation of 17 body areas on a 0 to 3 scale (normal, mild, moderate, severe). The m-Rodnan total skin thickness score was derived by summation of the scores from all 17 body areas. Using the m-Rodnan, 6-7 investigators assessed skin thickness in 5-6 patients with SSc (22 patients and 23 examiners total) at each of 4 sessions for the determination of interobserver variability (accuracy). In addition 21 of the investigators then assessed m-Rodnan in 2-3 patients each (60 patients total) 3 times over a 2-8 week period to quantitate intraobserver variability (reliability). Results. Interobserver and intraobserver mean ± within patient standard deviations (SD) for the m-Rodnan were found to be 17.7 ± 4.6 and 20.7 ± 2.45, respectively. Conclusion. The m-Rodnan total skin thickness score is at least as reliable for measuring skin thickness in SSc as are the ARA and Ritchie joint tenderness counts for assessing joint disease in rheumatoid arthritis. These data are useful for the determination of sample size and for the definitions of clinically meaningful response. Assessment of skin score is sufficiently reproducible to include as a measure of disease outcome, especially if patients are serially evaluated by the same investigator.

KW - Scleroderma

KW - Skin score

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