{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T03:34:44Z","timestamp":1752550484328},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2016,4,29]],"date-time":"2016-04-29T00:00:00Z","timestamp":1461888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Skin tightness progression determines the severity and mortality of systemic sclerosis (<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c). The modified Rodnan skin score (<jats:styled-content style=\"fixed-case\">mRSS<\/jats:styled-content>) is a skin tightness assessment tool, albeit inter\u2010physician variability is a limitation. Our objectives were to evaluate the correlation and agreement of skin tightness assessment between patient self\u2010assessment and physician\u2010assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A descriptive study was conducted on the masked, self\u2010assessments of <jats:styled-content style=\"fixed-case\">mRSS<\/jats:styled-content> (at week 0, 4 and 12) by 23 Thai adult <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c patients seen at Srinagarind Hospital, KhonKaen University, between March 2014 and February 2015. Correlation between the physician and patient assessments was estimated using Pearson's. The intra\u2010class correlation coefficient (<jats:styled-content style=\"fixed-case\">ICC<\/jats:styled-content>) and limit of agreement by Bland\u2010Altman were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 23 <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c patients (female to male ratio being 1.1:1). All had the diffuse cutaneous <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c subset. The skin thickness assessment correlation was moderate at baseline (Pearson's <jats:italic>r<\/jats:italic> = 0.68) and improved to a good correlation at week 4 and 12 (<jats:italic>r<\/jats:italic> = 0.78 and 0.86, respectively). The <jats:styled-content style=\"fixed-case\">ICC<\/jats:styled-content> showed good agreement (0.761) at week 0 and increased to excellent at week 4 (0.846) and 12 (0.910). The patient self\u2010assessment score was higher than the physician assessment, which slightly decreased over time: mean difference = 4.30 (95% <jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content>;\u22129.54 to 18.14) at week 0, then 3.78 (95% <jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content>,\u221210.20 to 17.77) at week 4, and 3.16 (95% <jats:styled-content style=\"fixed-case\">LOA<\/jats:styled-content>,\u22127.78 to 14.10) at week 12.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The respective modified Rodnan skin score assessment by patient versus the physician was highly correlated with a high level of agreement. Validation of generalized patient self\u2010assessment needs to be confirmed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.12879","type":"journal-article","created":{"date-parts":[[2016,4,30]],"date-time":"2016-04-30T13:50:50Z","timestamp":1462024250000},"page":"989-995","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Self\u2010assessment of skin tightness severity by scleroderma patients"],"prefix":"10.1111","volume":"19","author":[{"given":"Kittikorn","family":"Daungkum","sequence":"first","affiliation":[{"name":"Department of Medicine Faculty of Medicine Khon Kaen University Khon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chingching","family":"Foocharoen","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medicine Khon Kaen University Khon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajanee","family":"Mahakkanukrauh","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medicine Khon Kaen University Khon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siraphop","family":"Suwannaroj","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medicine Khon Kaen University Khon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bandit","family":"Thinkhamrop","sequence":"additional","affiliation":[{"name":"Faculty of Public Health Khon Kaen University Khon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ratanavadee","family":"Nanagara","sequence":"additional","affiliation":[{"name":"Department of Medicine Faculty of Medicine Khon Kaen University Khon Kaen Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,4,29]]},"reference":[{"issue":"2","key":"e_1_2_9_2_1","first-page":"202","article-title":"Scleroderma (systemic sclerosis): classification, subsets and pathogenesis","volume":"15","author":"LeRoy EC","year":"1988","journal-title":"J Rheumatol"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200011)43:11<2445::AID-ANR11>3.0.CO;2-Q"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200112)44:12<2828::AID-ART470>3.0.CO;2-U"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780330828"},{"issue":"7","key":"e_1_2_9_6_1","first-page":"1281","article-title":"Inter and intraobserver variability of total skin thickness score (modified Rodnan TSS) in systemic sclerosis","volume":"22","author":"Clements P","year":"1995","journal-title":"J Rheumatol"},{"issue":"11","key":"e_1_2_9_7_1","first-page":"1892","article-title":"Skin thickness score in systemic sclerosis: an assessment of interobserver variability in 3 independent studies","volume":"20","author":"Clements PJ","year":"1993","journal-title":"J Rheumatol"},{"issue":"1","key":"e_1_2_9_8_1","first-page":"84","article-title":"The modified Rodnan skin score is an accurate reflection of skin biopsy thickness in systemic sclerosis","volume":"25","author":"Furst DE","year":"1998","journal-title":"J Rheumatol"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kel451"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199906)42:6<1194::AID-ANR16>3.0.CO;2-7"},{"issue":"7","key":"e_1_2_9_11_1","first-page":"1271","article-title":"Variability of skin scores and clinical measurements in scleroderma","volume":"22","author":"Pope JE","year":"1995","journal-title":"J Rheumatol"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1756-185X.2012.01760.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780230510"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780220205"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4377-1738-9.00084-0"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19980115)17:1<101::AID-SIM727>3.0.CO;2-E"},{"issue":"7","key":"e_1_2_9_17_1","first-page":"1277","article-title":"Is it possible to reduce observer variability in skin score assessment of scleroderma? 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