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Background: Chronic plaque-type psoriasis is a major dermatosis, but a significant question is still unanswered: What defines severity in chronic plaque-type psoriasis? While objective assessments like the Psoriasis Area and Severity Index (PASI) have frequently been used in clinical trials, quality of life (QOL) questionnaires are currently becoming more and more popular. Objective: This article summarizes the most important objective and subjective measurements of severity in psoriasis. For every dermatologist it is critically important to distinguish between severe psoriasis and psoriasis that severely affects QOL. Even if the PASI also has disadvantages, it is the most adequate instrument available to evaluate severity in plaque-type psoriasis. Result: We provide reasons why PASI >12 defines severe, PASI 7–12 moderate and PASI <7 mild chronic plaque-type psoriasis. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Introducción: Actualmente, los traumatismos son considerados la sexta causa de mortalidad y la quinta causa de discapacidad en todos los grupos etarios. Uno de los factores más importantes en la supervivencia de un paciente traumatizado es el tiempo de injuria. Objetivo: Estimar la asociación entre el tiempo de injuria y el nivel de estatus funcional al alta en pacientes adultos con trauma enrolados en el ensayo CRASH-2 durante los años 2005-2010. Métodos: Estudio de tipo cohorte retrospectiva que corresponde a un análisis secundario de la base de datos del ensayo experimental CRASH-2. Se calculó el riesgo relativo (RR) del tiempo de injuria que se define como el intervalo de tiempo que inicia desde el momento del accidente hasta la el arribo al hospital y estatus funcional mediante un modelo lineal generalizado de la familia Poisson, link log con varianza robusta con un intervalo de confianza al 95% ajustado por edad, sexo, tipo de injuria, accidente cerebro vascular (ACV), traumatismo encéfalo craneano (TEC) y eventos vasooclusivos. Resultados: Se analizó la información de 16,950 pacientes para este estudio. El 66.97% de los pacientes tuvieron un tiempo no prolongado (≤ 3 horas) y el 76.77% presentaron un estatus funcional independiente al alta. Encontramos que los pacientes que tuvieron un tiempo de injuria prolongado tienen un 11.00% más riesgo de presentar un estatus funcional dependiente en comparación a los pacientes con tiempo de injuria no prolongado. Conclusión: Nuestro estudio apoya el rápido transporte de pacientes con trauma ante la relación entre un tiempo de injuria prolongado y el desarrollo de un estatus funcional dependiente. / Introduction: Currently, trauma is considered the sixth global cause of mortality and fifth cause of disability in all age groups. . One of the most important factors in the survival of an injured patient is the injury time. Objective: To estimate the association between injury time and functional status at discharge in adult trauma patients enrolled in the CRASH-2 trial during the years 2005-2010. Methods: Retrospective cohort study corresponding to a secondary analysis of the CRASH-2 experimental trial database. The relative risk (RR) of time of injury (defined as the time interval from the time of the injury to hospital arrival) and functional status was calculated using a generalized linear model of the Poisson family, link log with robust variance with a 95% confidence interval adjusted for age, sex, type of injury, stroke, traumatic brain injury (TBI) and vaso-oclusive events. Results: Data from 16,950 patients were analyzed for this study. The 66.97% of the patients had a non-prolonged injury time (≤ 3 hours) and 76.77% presented an independent functional status at discharge. We found that patients who had a prolonged injury time had a 11.00% higher risk of presenting a dependent functional status compared to patients with a non-prolonged injury time. Other factors associated with dependent functional status are age, type of injury, stroke, TBI, among others. Conclusions: Our study concludes that a prolonged injury time increases the risk of developing a dependent functional status and due to this result, we encourage the rapid transportation of trauma patients to reduce the risk of dependent functional status. / Tesis

Propósito: Evaluar el valor del Vesikari Scoring System (VSS) como herramienta diagnóstica en la predicción de patógenos en niños con gastroenteritis aguda. Métodos: En un estudio retrospectivo, se analizó 247 historias clínicas y registros laboratoriales del Hospital de Emergencias Pediátricas (Lima, Perú), utilizando el diagnóstico de CIE-10 A00-A009 (enfermedades intestinales infecciosas). Se dividió según los patógenos detectados: no específico, viral y bacteriana. Se detectaron las bacterianas por coprocultivo y las virales por inmunoanálisis. Los casos no específicos tenían ambos resultados negativos o no hubo pruebas laboratoriales. Se ha calculado la sensibilidad, especificidad, valores predictivos negativos (VPN) y positivos (VPP), índice de probabilidad (LR) y el área bajo la curva (ROC). Resultado: El área bajo la curva ROC del VSS no fue significativo para determinar la etiología bacteriana ni viral. En el punto de corte de 9 en VSS, se analizó VPP (18.29%) y VPN (89.47%). Los leucocitos en heces tuvieron un área bajo la curva ROC de 0.8831(IC95% 0,79-0,96 y p=0.04) para etiología bacteriana, con una sensibilidad de 80.95%, especificidad de 88.24% y LR- de 0.22. Los leucocitos en heces con un punto de corte de ≥20, tuvo una precisión aceptable para diagnosticar gastroenteritis bacteriana. La prueba de moco en heces tuvo una sensibilidad de 83.33%, especificidad de 82.35% y VPP de 95.89%. Conclusión: El VSS no es una herramienta adecuada para determinar etiología de gastroenteritis viral y bacteriana. Sin embargo, se ha determinado que los leucocitos en heces con un punto de corte de ≥20 leucocitos por campo y moco en heces permite identificar la gastroenteritis aguda bacteriana. / Purpose: To evaluate the Vesikari Scoring System (VSS) as a valuable diagnostic tool for predicting pathogens in children with acute gastroenteritis. Methods: In this retrospective study were analyzed 247 clinical and laboratory records of the Pediatric Emergency Hospital (Lima, Peru), with the diagnosis of ICD-10 A00-A009 (Intestinal Infectious diseases). According to the pathogens detected were divided into groups: non-specific, viral, and bacterial. Bacteria were detected by stool culture, viral pathogens by immune analysis. The non-specific group had negative on both tests, or they did not perform. We calculated sensitivity, specificity, negative and positive predictive values, negative and positive likelihood ratios, and receiver operating characteristic curves.  Results: The area under the ROC curve of VSS was not significant for viral and bacterial etiology. The cut-off point of 9 in VSS was calculated by analyzing PPV (18,29%) and NPV (89,47%). The fecal leukocyte had a ROC of 0.8831 (IC95% 0.79-0.96 and p=0.04) for bacterial group, with a sensibility of 80,95%, specificity of 88,24% and LR- of 0,22. At a cut-off point of ≥20 fecal leukocytes was an acceptable diagnostic accuracy for bacterial gastroenteritis. The stool mucus for the bacterial group had a sensibility of 83,33%, a specificity of 82,35%, and a PPV of 95,89%. Conclusion: VSS is not an adequate diagnostic tool to differentiate viral from bacterial etiology. Nevertheless, we determine that a test of fecal leukocytes, with a cut-off point of ≥20 leukocytes per field and mucus in stools, allow us to identify the bacterial etiology of gastroenteritis. / Tesis

The objective of this research was to develop an optimal design for a polymeric American football helmet liner for concussion prevention utilizing experiments and high performance. Along with well-established injury criteria (HIC, SI, and Peak acceleration), localized brain injury mechanisms were explored by employing Finite Element simulations and experimental validation. Varying strain rate experiments (monotonic and hysteresis) were conducted on modern football helmet (Rush, Rawlings, Riddell, Schutt, and Xenith) liners and new possible polymeric foam liner materials. These experiments were used to characterize each material at low strain rates (0.1/sec; Instron), intermediate strain rates (100-120/sec; NOCSAE drop tower) and high strain rates (600-1000/sec; Split Hopkinson Pressure Bar). Experimental design optimization was performed on a football helmet liner by utilizing an exploratory Design of Experiments by National Operating Committee on Standards for Athletic Equipment (NOCSAE) drop tests. FEA simulations of drop impact tests were conducted on a helmeted NOCSAE headform model and a helmeted human head model. Correlations were made between both models to relate localized brain response to the global acceleration and the dynamic-based injury criteria HIC, SI, and Peak acceleration). FEA simulations were experimentally validated by twin-wire drop tests of the NOCSAE headform using correlations for validation of the human head model. The helmeted human head simulations were used to explore a Mild Traumatic Brain Injury (MTBI) limits based localized brain response (e.g. pressure and impulse). Based on these limits, future FEA simulations will be used to explore these limits as helmet liner design criteria.

Insomni är ett vanligt problem och det finns behov av ökad tillgänglighet till kostnadseffektiva behandlingar. Syftet var att undersöka om en enkomponentsbehandling (EK), bestående av sömnrestriktion/sömnkomprimering, var non-inferior till en multikomponent (MK) KBT- behandling vid insomni och om det fanns en skillnad i symtomreduktion. Gränsvärden för non- inferiority var d = 0.8, utifrån tidigare forskning, respektive en strängare gräns d = 0.4. Data från en forskningsstudie där deltagarna erhöll EK (n = 193) jämfördes mot en riktlinje i form av en KBT-behandling i reguljärvården, MK (n = 289). Båda grupper erhöll behandling via samma internetplattform, och Insomnia Severity Index (ISI) användes som utfallsmått. Resultaten visade att EK inte kunde bekräftas som non-inferior till MK direkt efter behandling eller vid 1-årsuppföljning när en sträng gräns användes. När en liberal gräns användes kunde EK bekräftas som non-inferior direkt efter behandling men inte ett år senare. Direkt efter behandling och vid 1-årsuppföljningen visade båda grupperna en signifikant minskning av insomnisymtom, men vid 1-årsuppföljningen visade MK en större minskning. Ett stort bortfall vid 1-årsuppföljning och mer terapeutstöd för MK kan ha påverkat resultaten. Fler RCT-studier med långtidsuppföljningar behövs inom området, och även studier på andra populationer. MK är att föredra, men vid begränsade resurser kan EK erbjudas med god effekt på både kort och lång sikt. / Insomnia is a common problem and there is a need for increased accessibility to cost-effective treatments. The purpose was to examine if an one-component treatment (EK), consisting of sleep-restriction/sleep-compression, were non-inferior to a multi-component (MK) CBT treatment for insomnia and if there was a difference in symptom reduction. The prestated margins for non-inferiority were d = 0.8, based on previous research, and a stricter margin of d = 0.4. Data from a research study where participants received EK (n = 193) was compared to a benchmark consisting of a CBT treatment in regular health care (MK) (n = 289). Both groups received treatment at the same Internet platform, and Insomnia Severity Index (ISI) was used as outcome measurement. The results showed that EK could not be confirmed as non-inferior to MK directly after treatment or at the one-year follow up when using a strict limit. When a liberal limit was used, EK could be confirmed as non-inferior directly after treatment but not one year later. Directly after treatment and at the one-year follow up both groups showed a significant symptom reduction, but at the one-year follow up MK showed a greater reduction. A large number of missing data at the one-year follow up and more therapeutic support in MK may have affected the results. More RCT-studies with longterm follow ups are needed in the area, and also studies of other populations. MK is preferable, but with limited resources EK can be offered with good effect both short term and long term.

Résumé : Introduction : L’ataxie récessive spastique de Charlevoix-Saguenay (ARSCS) est une maladie héréditaire dégénérative présentant un taux élevé de porteurs (1/22) au Saguenay-Lac-Saint-Jean, mais aussi retrouvée à l’échelle mondiale. Les personnes atteintes présentent des atteintes cérébelleuses (ataxie), neuropathiques (amyotrophie) et pyramidales (spasticité). L’ARSCS présente un portrait différent des autres types d’ataxies et il n’existe pas d’échelle de gravité spécifique pour évaluer la progression de la maladie ou évaluer l’efficacité d’un traitement. Méthodologie : Les objectifs de ce projet sont de développer et documenter les qualités métrologiques des items de la section pyramidale de l’échelle de gravité de l’ARSCS (Disease Severity Index for Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay, DSI-ARSACS). La section pyramidale a été élaborée à l’aide du modèle de développement de Streiner et Norman (2008). La planification et la construction ont été réalisées à l’aide d’une recension systématique des écrits et d’une consultation Delphi. La validité de construit (convergente et discriminatoire) et la fidélité (intraévaluateur et interévaluateurs [n=2]) ont été documentées. Vingt-huit (28) participants âgés de 18 à 59 ans ont été recrutés, selon un échantillonnage stratifié pour l’âge et le sexe. Le diagnostic devait être confirmé génétiquement. La validité convergente a été documentée avec des outils évaluant le contrôle moteur aux membres inférieurs (LEMOCOT), la gravité de la spasticité (SPRS), la mobilité (6MWT, 10mWT, échelle de Berg), le fonctionnement dans les activités quotidiennes (Index de Barthel), la participation sociale (MHAVIE) et la qualité de vie (SF-12v2). La validité discriminatoire a été documentée selon le sexe, le groupe d’âge et le stade de la maladie. La section pyramidale a été administrée à trois reprises par deux physiothérapeutes, à deux semaines d’intervalle, pour évaluer la fidélité intra/interévaluateurs. Résultats : La validité de contenu a été jugée adéquate par les experts du domaine. La validité de construit convergente est soutenue par des corrélations élevées avec les outils mesurant des concepts apparentés (r > 0,7, p = 0,00), à l’exception du SF-12v2 (r = 0,09-0,33). La validité de construit discriminatoire est appuyée par la capacité de distinguer les personnes atteintes en fonction des groupes d’âge et des stades de la maladie. La fidélité intra/interévaluateurs est excellente pour les items individuels (κ[indice inférieur w] = 0,68-0,96/0,60-0,95 sauf pour deux items κ[indice inférieur w] = 0,12 et 0,47) et pour le sous-total pyramidal (CCI = 0,94/0,88, p = 0,000). La cohérence interne (α = 0,85) témoigne de l’homogénéité des items pyramidaux. Conclusion : Le sous-total pyramidal du DSI-ARSACS a démontré une excellente validité de construit convergente et discriminatoire et une bonne fidélité. L’échelle de gravité permettra de mieux documenter l’évolution naturelle de la maladie. / Abstract : Introduction: Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is a hereditary and degenerative illness that has a high carrier rate (1/22) in Saguenay-Lac-St-Jean (Quebec, Canada) but that is also found elsewhere around the world. Individuals with ARSACS have cerebellar impairments (ataxia), neuropathic impairments (amyotrophy) and pyramidal impairments (spasticity). ARSACS does not have the same characteristics as other forms of ataxia and there is currently no specific disease severity index (DSI) for it. Method: This project aimed to develop the items of the pyramidal section of the DSI-ARSACS and document their metrological properties. A literature review was conducted to identify ARSACS’ related impairments and existing scales measuring pyramidal impairments. Both items from known scales and new items were used to build a new scale that would assess the pyramidal impairments associated with ARSACS. The scale’s content validation was based on expert opinion. A consensus on the final scale composition was reached. Two physiotherapists administered the newly developed scale to 28 participants with a genetically confirmed ARSACS diagnosis in order to document the reliability of the pyramidal section of the DSI. Existing scales related to pyramidal impairments, mobility, social participation and quality of life were administered to assess convergent construct validity. The contrasting group method (age group, disease stage, gender) was used to assess discriminant validity. Results: Content validity was considered adequate by an expert panel that completed a Delphi process. The pyramidal section’s subscore was distributed normally and did not show a ceiling/floor effect. Convergent construct validity was supported by strong correlations with existing scales measuring related constructs (r > 0.7, p = 0.00), excluding SF-12 v2 (r = 0.09-0.33). Discriminant construct validity was supported by the scale’s ability to distinguish subjects according to age and disease stage. Intra/inter-rater reliability was excellent for individual items (κ[subscript w] = 0.68-0.96/0.60-0.95), except for two items (κ[subscript w] = 0.12 and 0.47), and also excellent for the section’s subscore (CCI = 0.94/0.88, p = 0.000). Internal consistency (α = 0.85) reflected the homogeneity of the pyramidal items. Conclusion: The pyramidal section’s subscore of DSI-ARSACS displayed excellent metrological properties (discriminative and convergent validity, reliability) during this initial validation. The index will lead to a better understanding of ARSACS’ natural history while also allowing for the categorization of subjects participating in future clinical trials.

Objetivos: O objetivo deste estudo foi avaliar o efeito da suplementação de vitamina D nos parâmetros clínicos, laboratoriais, atividade da doença, e fadiga em pacientes com lúpus eritematoso de início juvenil (LESj). Métodos: Este trabalho foi um estudo randomizado, duplo-cego, controlado por placebo por um período de 24 semanas. Quarenta pacientes foram randomizadas (1:1) para receber colecalciferol via oral 50.000 UI / semana (LESj-VITD) ou placebo (LESj-PL). A terapêutica destes pacientes foi mantida estável durante este período. As concentrações séricas de 25- hidroxivitamina D (25OHD) foram medidas por radioimunoensaio. A atividade da doença foi avaliada por meio do Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) e pelo European Consensus Lupus Activity Measurement (ECLAM). Fadiga foi avaliada usando a Kids Fatigue Severity Scale (K-FSS). Resultados: No início do estudo, os grupos foram semelhantes em relação à idade, índice de massa corporal, envolvimento de órgãos, dose de glicocorticoide, uso de drogas imunossupressoras, SLEDAI, ECLAM, K-FSS e concentrações séricas de 25OHD. Após 24 semanas, as concentrações séricas de 25OHD foram maiores no grupo LESj-VITD que no LESj-PL [(31,3 (8,7) vs. 16,5 (5,8), p < 0,001)]. Ao fim da intervenção, uma melhoria significativa no SLEDAI [Delta= 0 (- 4 - 5)_ vs. 1 (-12 - 6) p =0,011] e no ECLAM [Delta = 0 (-2 -1) vs. 0 (-6 - 3) p=0,006], foi observado no grupo LESj- VITD em comparação com o LESj-PL. Em relação à avaliação de fadiga, uma redução da fadiga relacionada com a vida social foi encontrada no grupo LESj-VITD em comparação com o grupo LESj-PL (p = 0,008). A suplementação de colecalciferol foi bem tolerada sem eventos adversos graves. Conclusões: Este estudo sugere que a suplementação com colecalciferol por 24 semanas é eficaz em diminuir a atividade da doença e melhorar a fadiga em pacientes com LESj / Objective: The aim of this study was to evaluate the effect of vitamin D supplementation on disease activity and fatigue in Juvenile-onset Systemic Lupus Erythematosus (JoSLE). Methods: This study was a randomized double-blind placebo-controlled 24-week trial. Forty JoSLE patients were randomized (1:1) to receive oral cholecalciferol 50,000 IU/week (JoSLE-VitD) or placebo (JoSLE-PL). Medications remained stable throughout the study. Serum levels of 25OHD were measured using radioimmunoassay. Disease activity was assessed using the SLE Disease Activity Index (SLEDAI) and the European Consensus Lupus Activity Measurement (ECLAM). Fatigue was assessed using the Kids Fatigue Severity Scale (K-FSS). Results: At baseline, groups were similar regarding, age, body mass index, organ involvement, glucocorticoid dose, use of immunosuppressive drugs, SLEDAI, ECLAM, K-FSS and levels of 25OHD. After 24 weeks, the mean level of 25OHD was higher in the JoSLE-VitD group than in the JoSLE-PL [(31,3 (8,7) vs. 16,5 (5,8), p < 0,001)]. At the end of intervention, a significant improvement in SLEDAI [delta= 0 (- 4 - 5)_ vs. 1 (-12 - 6) p =0,011] and in ECLAM [delta = 0 (-2 -1) vs. 0 (-6 - 3) p=0,006] was observed in the JoSLE-VitD group compared to the JoSLE-PL. Regarding fatigue evaluation, a reduction of fatigue related to social life score was found in the JoSLE-VitD group compared to the JoSLE-PL group (p=0.008). Cholecalciferol was well tolerated with no serious adverse events. Conclusion: This study suggests that cholecalciferol supplementation for 24 weeks is effective in decreasing disease activity and improving fatigue in JoSLE patients

Objetivos: O objetivo deste estudo foi avaliar o efeito da suplementação de vitamina D nos parâmetros clínicos, laboratoriais, atividade da doença, e fadiga em pacientes com lúpus eritematoso de início juvenil (LESj). Métodos: Este trabalho foi um estudo randomizado, duplo-cego, controlado por placebo por um período de 24 semanas. Quarenta pacientes foram randomizadas (1:1) para receber colecalciferol via oral 50.000 UI / semana (LESj-VITD) ou placebo (LESj-PL). A terapêutica destes pacientes foi mantida estável durante este período. As concentrações séricas de 25- hidroxivitamina D (25OHD) foram medidas por radioimunoensaio. A atividade da doença foi avaliada por meio do Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) e pelo European Consensus Lupus Activity Measurement (ECLAM). Fadiga foi avaliada usando a Kids Fatigue Severity Scale (K-FSS). Resultados: No início do estudo, os grupos foram semelhantes em relação à idade, índice de massa corporal, envolvimento de órgãos, dose de glicocorticoide, uso de drogas imunossupressoras, SLEDAI, ECLAM, K-FSS e concentrações séricas de 25OHD. Após 24 semanas, as concentrações séricas de 25OHD foram maiores no grupo LESj-VITD que no LESj-PL [(31,3 (8,7) vs. 16,5 (5,8), p < 0,001)]. Ao fim da intervenção, uma melhoria significativa no SLEDAI [Delta= 0 (- 4 - 5)_ vs. 1 (-12 - 6) p =0,011] e no ECLAM [Delta = 0 (-2 -1) vs. 0 (-6 - 3) p=0,006], foi observado no grupo LESj- VITD em comparação com o LESj-PL. Em relação à avaliação de fadiga, uma redução da fadiga relacionada com a vida social foi encontrada no grupo LESj-VITD em comparação com o grupo LESj-PL (p = 0,008). A suplementação de colecalciferol foi bem tolerada sem eventos adversos graves. Conclusões: Este estudo sugere que a suplementação com colecalciferol por 24 semanas é eficaz em diminuir a atividade da doença e melhorar a fadiga em pacientes com LESj / Objective: The aim of this study was to evaluate the effect of vitamin D supplementation on disease activity and fatigue in Juvenile-onset Systemic Lupus Erythematosus (JoSLE). Methods: This study was a randomized double-blind placebo-controlled 24-week trial. Forty JoSLE patients were randomized (1:1) to receive oral cholecalciferol 50,000 IU/week (JoSLE-VitD) or placebo (JoSLE-PL). Medications remained stable throughout the study. Serum levels of 25OHD were measured using radioimmunoassay. Disease activity was assessed using the SLE Disease Activity Index (SLEDAI) and the European Consensus Lupus Activity Measurement (ECLAM). Fatigue was assessed using the Kids Fatigue Severity Scale (K-FSS). Results: At baseline, groups were similar regarding, age, body mass index, organ involvement, glucocorticoid dose, use of immunosuppressive drugs, SLEDAI, ECLAM, K-FSS and levels of 25OHD. After 24 weeks, the mean level of 25OHD was higher in the JoSLE-VitD group than in the JoSLE-PL [(31,3 (8,7) vs. 16,5 (5,8), p < 0,001)]. At the end of intervention, a significant improvement in SLEDAI [delta= 0 (- 4 - 5)_ vs. 1 (-12 - 6) p =0,011] and in ECLAM [delta = 0 (-2 -1) vs. 0 (-6 - 3) p=0,006] was observed in the JoSLE-VitD group compared to the JoSLE-PL. Regarding fatigue evaluation, a reduction of fatigue related to social life score was found in the JoSLE-VitD group compared to the JoSLE-PL group (p=0.008). Cholecalciferol was well tolerated with no serious adverse events. Conclusion: This study suggests that cholecalciferol supplementation for 24 weeks is effective in decreasing disease activity and improving fatigue in JoSLE patients

Meteorological drought indices are commonly calculated from climatic stations that have long-term historical data and then converted to a regular grid using spatial interpolation methods. The gridded drought indices are mapped to aid decision making by policy makers and the general public. This study analyzes the spatial performance of interpolation methods for meteorological drought indices in the United States based on data from the Co-operative Observer Network (COOP) and United States Historical Climatology Network (USHCN) for different months, climatic regions and years. An error analysis was performed using cross-validation and the results were compared for the 9 climate regions that comprise the United States. Errors are generally higher in regions and months dominated by convective precipitation. Errors are also higher in regions like the western United States that are dominated by mountainous terrain. Higher errors are consistently observed in the southeastern U.S. especially in Florida. Interpolation errors are generally higher in the summer than winter. The accuracy of different drought indices was also compared. The Standardized Precipitation and Evapotranspiration Index (SPEI) tends to have lower errors than Standardized Precipitation Index (SPI) in seasons with significant convective precipitation. This is likely because SPEI uses both precipitation and temperature data in its calculation, whereas SPI is based solely on precipitation. There are also variations in interpolation accuracy based on the network that is used. In general, COOP is more accurate than USHCN because the COOP network has a higher density of stations. USHCN is a subset of the COOP network that is comprised of high quality stations that have a long and complete record. However the difference in accuracy is not as significant as the difference in spatial density between the two networks. For multiscalar SPI, USHCN performs better than COOP because the stations tend to have a longer record. The ordinary kriging method (with optimal function fitting) performed better than Inverse Distance Weighted (IDW) methods (power parameters 2.0 and 2.5) in all cases and therefore it is recommended for interpolating drought indices. However, ordinary kriging only provided a statistically significant improvement in accuracy for the Palmer Drought Severity Index (PDSI) with the COOP network. Therefore it can be concluded that IDW is a reasonable method for interpolating drought indices, but optimal ordinary kriging provides some improvement in accuracy. The most significant factor affecting the spatial accuracy of drought indices is seasonality (precipitation climatology) and this holds true for almost all the regions of U.S. for 1-month SPI and SPEI. The high-quality USHCN network gives better interpolation accuracy with 6-, 9- and 12-month SPI and variation in errors amongst the different SPI time scales is minimal. The difference between networks is also significant for PDSI. Although the absolute magnitude of the differences between interpolation with COOP and USHCN are small, the accuracy of interpolation with COOP is much more spatially variable than with USHCN.