The development of a symptom-based clinical activity score for thyroid eye disease
CE Elder, BW Fleck & S Rajack
Background: Mourits clinical activity score (CAS) is commonly used in assessing disease activity in patients with thyroid eye disease (TED). However measurements must be taken on more than one occasion, and specialised ophthalmic equipment is needed.
Aim: To develop a symptom-based TED clinical activity score.
Methods: The Mourits Clinical Activity Score (CAS) was modified to produce a CAS based only on symptoms. 15 patients were recruited from a TED clinic at an Eye Hospital. Patients were asked categorical questions to produce a symptom based CAS. Clinical activity was then assessed by a second, blind, observer using Mourits CAS. The conventional and modified clinical activity scores were compared. Local Ethical Committee approval was obtained before commencing the study.
Results: The mean conventional CAS was 1.2 (range 0.06.0) and the mean modified CAS was 3.87 (range 0.010.0). There was no significant correlation between the 2 scores, ρ=0.07.
Conclusion: The modified CAS did not correlate with the conventional CAS and cannot therefore be recommended for clinical use.