Validation of the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-4, a simplified severity scale for assessing skin lesions of atopic dermatitis in dogs

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dc.contributor.authorOlivry, T.
dc.contributor.authorSaridomichelakis, M.
dc.contributor.authorNuttall, T.
dc.contributor.authorBensignor, E.
dc.contributor.authorGriffin, C.
dc.contributor.authorHill, P.
dc.date.issued2014
dc.description.abstractBACKGROUND: Severity scales are used to grade skin lesions in clinical trials for treatment of dogs with atopic dermatitis (AD). At this time, only two scales have been validated, namely the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-3 and the Canine Atopic Dermatitis Lesion Index (CADLI). However, the high number of assessed sites makes the CADESI-3 impractical. HYPOTHESIS/OBJECTIVES: The aim of this study was to develop and validate a fourth version of the CADESI that is simpler and quicker to administer. METHODS: Body sites, lesions and severity grades were revised by members of the International Committee on Allergic Diseases of Animals (ICADA). The newly designed CADESI-4 was tested for its validity (i.e. content, construct and criterion), reliability (i.e. inter- and intra-observer reliability and internal consistency), responsiveness (i.e. sensitivity to change) and time to administer. Disease severity benchmarks were chosen using receiver operating characteristic methodology. RESULTS: The CADESI-4 was simplified in comparison to its previous version to comprise 20 body sites typically affected in atopic dogs. Three lesions (erythema, lichenification and alopecia/excoriation) were scored from 0 to 3 at each site. The CADESI-4 had satisfactory validity, reliability and sensitivity to change. On average, the time to administer a CADESI-4 was one-third that of a CADESI-3. Proposed benchmarks for mild, moderate and severe AD skin lesions are 10, 35 and 60, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: The CADESI-4 is simpler to use and quicker to administer than its previous version. The ICADA recommends the CADESI-4 instead of the CADESI-3 to score skin lesions of AD in dogs enrolled in clinical trials.
dc.description.statementofresponsibilityThierry Olivry, Manolis Saridomichelakis, Tim Nuttall, Emmanuel Bensignor, Craig E. Griffin, and Peter B. Hill for the International Committee on Allergic Diseases of Animals, ICADA
dc.identifier.citationVeterinary Dermatology, 2014; 25(2):77-e25
dc.identifier.doi10.1111/vde.12107
dc.identifier.issn0959-4493
dc.identifier.issn1365-3164
dc.identifier.orcidHill, P. [0000-0002-7449-4897]
dc.identifier.urihttp://hdl.handle.net/2440/91546
dc.language.isoen
dc.publisherWiley
dc.rights© 2014 ESVD and ACVD
dc.source.urihttps://doi.org/10.1111/vde.12107
dc.subjectInternational Committe on Allergic Diseases of Animals (ICADA)
dc.subjectAnimals
dc.subjectDogs
dc.subjectDermatitis, Atopic
dc.subjectPruritus
dc.subjectDog Diseases
dc.subjectPain Measurement
dc.subjectSeverity of Illness Index
dc.subjectReproducibility of Results
dc.titleValidation of the Canine Atopic Dermatitis Extent and Severity Index (CADESI)-4, a simplified severity scale for assessing skin lesions of atopic dermatitis in dogs
dc.typeJournal article
pubs.publication-statusPublished

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