Validation of an Oral Disease Severity Score (ODSS) tool for use in oral mucous membrane pemphigoid
M Ormond  H McParland  P Thakrar  A N A Donaldson  M Andiappan  R J Cook  M E Escudier  J Higham  E Hullah  R McMillan  J Taylor  P J Shirlaw  S J Challacombe  J F Setterfield
First published: 30 September 2019 https://doi.org/10.1111/bjd.18566
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/bjd.18566
ePDFPDFTOOLS SHARE
Abstract
Background
Mucous membrane pemphigoid (MMP) is a rare autoimmune bullous disease predominantly affecting the oral mucosa. Optimal management relies upon thorough clinical assessment and documentation at each visit.

Objectives
The primary aim of this study was to validate the Oral Disease Severity Score (ODSS) for the assessment of oral involvement in MMP. We also compared its inter‐ and intra‐observer reliability with the oral parts of the Mucous Membrane Pemphigoid Disease Area Index (MMPDAI), Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and Physician’s Global Assessment (PGA).

Methods
Fifteen patients with mild to moderately severe oral MMP were scored for disease severity by 10 oral medicine clinicians from four UK centres using the ODSS, the oral sections of MMPDAI and ABSIS and PGA. Two clinicians re‐scored all patients after two‐hours.

Results
Inter‐observer reliability for ODSS total score intra‐class correlation coefficient (ICC) was 0.97; MMPDAI activity 0.59 and damage 0.15; ABSIS total 0.84; and PGA 0.72. Intra‐observer ICC for ODSS total was 0.97 and 0.93; MMPDAI activity 0.93 and 0.70 and damage 0.93 and 0.79; ABSIS total 0.99 and 0.94; and PGA 0.92 and 0.94. Convergent validity between ODSS and MMPDAI was good (correlation coefficient 0.88). The mean±SD time (seconds) for completion, ODSS 93±31 s, MMPDAI 102±24 s and ABSIS involvement 71±18 s. The PGA was <5 s.

Conclusion
This study has validated the ODSS for the assessment of oral MMP. It has shown superior inter‐observer reliability than MMPDAI, ABSIS and PGA and intra‐observer reliability than MMPDAI. It is quick and easy to perform.

Supporting Information

Filename	Description
bjd18566-sup-0001-Supinfo.pptapplication/ppt, 575.5 KB	Supinfo

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.