Damage Index for Antiphospholipid Syndrome (DIAPS): An Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking (APS ACTION) “Damage” working group report on strengths and limitations

•DIAPS, a tool designed for quantifying damage in APS, presents limitations that need attention.•Our survey included the opinion of a large number of APS ACTION members.•Efforts for updating DIAPS should consider the APS ACTION “Damage” Working Group recommendations. To gather the perspectives of APS ACTION members regarding the strengths and limitations of Damage Index for Antiphospholipid Syndrome (DIAPS); and establish recommendations for the improvement of DIAPS. APS ACTION members were invited to answer a survey regarding their satisfaction with DIAPS scoring system and individual items. The level of agreement (LoA) among members with the inclusion of individual items in DIAPS was calculated (LoA of