Inter-rater reliability of cutaneous sarcoidosis assessment tools via remote photographic assessment

Sara A. Berg, Howa Yeung, Joseph C. English, Emily L. Keimig, Ellen J. Kim, Robert G. Micheletti, Karolyn A. Wanat, Marc A. Judson, Robert P. Baughman, Misha Rosenbach*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Recently two outcome instruments have been developed and validated for assessing cutaneous sarcoidosis in a live, in-person setting. Teledermatology is a rapidly growing field; yet, to date, no instrument has been validated for use in a remote setting, which could ultimately impact clinical trial design. Objective: To assess the interrater reliability of these outcome instruments for store-And-forward teledermatology. Methods: Seven sarcoidosis experts, including both pulmonologists and dermatologists, scored photographs of cutaneous sarcoidosis lesions in 13 patients utilizing the Cutaneous Sarcoidosis Activity and Morphology Index (CSAMI), the Sarcoidosis Activity and Severity Index (SASI) and the Physician Global Assessment (PGA). Interrater reliability was assessed for each instrument and was compared to results obtained from a prior study involving sarcoidosis experts evaluating the same patient population in an in-person setting. Results: Interrater reliability (presented as ICC [95%CI]) was poor for the CSAMI Activity scale (0.36 [0.16-0.65]) and the CSAMI Damage scale (0.17 [0.04-0.43]) and was fair for the Modified Facial SASI (0.59 [0.36-0.82]) and the PGA (0.47 [0.23-0.74]). All results were inferior to those obtained from the prior studies validating these instruments for in-person use. Conclusions: Given the superiority of these instruments when utilized in person, it is recommended to have an on-site sarcoidosis expert evaluate cutaneous sarcoidosis lesions whenever possible.

Original languageEnglish (US)
Pages (from-to)165-169
Number of pages5
JournalSarcoidosis Vasculitis and Diffuse Lung Diseases
Issue number2
StatePublished - Jan 1 2017


  • Cutaneous sarcoidosis
  • Outcome instruments
  • Reliability
  • Teledermatology

ASJC Scopus subject areas

  • Internal Medicine
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Fingerprint Dive into the research topics of 'Inter-rater reliability of cutaneous sarcoidosis assessment tools via remote photographic assessment'. Together they form a unique fingerprint.

Cite this