A cross-sectional study of the Birmingham Vasculitis Activity Score version 3 in systemic vasculitis

Ravi Suppiah; Chetan Mukhtyar; Oliver Flossmann; Federico Alberici; Bo Baslund; Rajbir Batra; Denise Brown; Julia Holle; Zdenka Hruskova; David R W Jayne; Andrew Judge; Mark A Little; Alessandra Palmisano; Coen Stegeman; Vladimir Tesar; Augusto Vaglio; Kerstin Westman; Raashid Luqmani

doi:10.1093/rheumatology/keq400

A cross-sectional study of the Birmingham Vasculitis Activity Score version 3 in systemic vasculitis

Ravi Suppiah, Chetan Mukhtyar, Oliver Flossmann, Federico Alberici, Bo Baslund, Rajbir Batra, Denise Brown, Julia Holle, Zdenka Hruskova, David R W Jayne, Andrew Judge, Mark A Little, Alessandra Palmisano, Coen Stegeman, Vladimir Tesar, Augusto Vaglio, Kerstin Westman, Raashid Luqmani

Norwich Medical School

Research output: Contribution to journal › Article › peer-review

93 Citations (Scopus)

Abstract

OBJECTIVE: Assessment of disease activity in vasculitis can be achieved using the BVAS, a clinical checklist of relevant symptoms, signs and features of active disease. The aim of this study was to revalidate the BVAS version 3 (BVAS v. 3) in a cohort of patients with systemic vasculitis.

METHODS: A total of 238 patients with vasculitis from seven countries in Europe were evaluated at a single time point. Spearman's correlation coefficients were calculated between BVAS v. 3 scores, vasculitis activity index (VAI), physician's global assessment (PGA), the physician's treatment decision, CRP and the vasculitis damage index (VDI) to demonstrate that the BVAS v. 3 measures disease activity.

RESULTS: WG (63%), Churg-Strauss syndrome (9%) and microscopic polyangiitis (9%) were the most common diagnoses. The BVAS v. 3 showed convergent validity with the VAI [ρ = 0.82 (95% CI 0.77, 0.85)], PGA [ρ = 0.85 (95% CI 0.81, 0.88)] and the physician's treatment decision [ρ = 0.54 (95% CI 0.44, 0.62)]. There was little or no correlation between BVAS v. 3 and the CRP level [ρ = 0.18 (95% CI 0.05, 0.30)] or with the VDI [ρ = -0.10 (95% CI 0.22, 0.03)]. The inter-observer reliability was very high with an intra-class correlation coefficient (ICC) of 0.996 (95% CI 0.990, 0.998) for the total BVAS v. 3 score.

CONCLUSION: The BVAS v. 3 has been evaluated in a large cohort of patients with vasculitis and the important properties of the tool revalidated. This study increases the utility of the BVAS v. 3 in different populations of patients with systemic vasculitis.

Original language	English
Pages (from-to)	899-905
Number of pages	7
Journal	Rheumatology
Volume	50
Issue number	5
Early online date	14 Dec 2010
DOIs	https://doi.org/10.1093/rheumatology/keq400
Publication status	Published - May 2011

Keywords

Adolescent
Adult
Aged
Aged, 80 and over
Churg-Strauss Syndrome/diagnosis
Cohort Studies
Cross-Sectional Studies
Europe/epidemiology
Female
Granulomatosis with Polyangiitis/diagnosis
Humans
Male
Microscopic Polyangiitis/diagnosis
Middle Aged
Observer Variation
Reproducibility of Results
Severity of Illness Index
Systemic Vasculitis/classification
Young Adult

Access to Document

10.1093/rheumatology/keq400

Cite this

Suppiah, R., Mukhtyar, C., Flossmann, O., Alberici, F., Baslund, B., Batra, R., Brown, D., Holle, J., Hruskova, Z., Jayne, D. R. W., Judge, A., Little, M. A., Palmisano, A., Stegeman, C., Tesar, V., Vaglio, A., Westman, K., & Luqmani, R. (2011). A cross-sectional study of the Birmingham Vasculitis Activity Score version 3 in systemic vasculitis. Rheumatology, 50(5), 899-905. https://doi.org/10.1093/rheumatology/keq400

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title = "A cross-sectional study of the Birmingham Vasculitis Activity Score version 3 in systemic vasculitis",

abstract = "OBJECTIVE: Assessment of disease activity in vasculitis can be achieved using the BVAS, a clinical checklist of relevant symptoms, signs and features of active disease. The aim of this study was to revalidate the BVAS version 3 (BVAS v. 3) in a cohort of patients with systemic vasculitis.METHODS: A total of 238 patients with vasculitis from seven countries in Europe were evaluated at a single time point. Spearman's correlation coefficients were calculated between BVAS v. 3 scores, vasculitis activity index (VAI), physician's global assessment (PGA), the physician's treatment decision, CRP and the vasculitis damage index (VDI) to demonstrate that the BVAS v. 3 measures disease activity.RESULTS: WG (63%), Churg-Strauss syndrome (9%) and microscopic polyangiitis (9%) were the most common diagnoses. The BVAS v. 3 showed convergent validity with the VAI [ρ = 0.82 (95% CI 0.77, 0.85)], PGA [ρ = 0.85 (95% CI 0.81, 0.88)] and the physician's treatment decision [ρ = 0.54 (95% CI 0.44, 0.62)]. There was little or no correlation between BVAS v. 3 and the CRP level [ρ = 0.18 (95% CI 0.05, 0.30)] or with the VDI [ρ = -0.10 (95% CI 0.22, 0.03)]. The inter-observer reliability was very high with an intra-class correlation coefficient (ICC) of 0.996 (95% CI 0.990, 0.998) for the total BVAS v. 3 score.CONCLUSION: The BVAS v. 3 has been evaluated in a large cohort of patients with vasculitis and the important properties of the tool revalidated. This study increases the utility of the BVAS v. 3 in different populations of patients with systemic vasculitis.",

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author = "Ravi Suppiah and Chetan Mukhtyar and Oliver Flossmann and Federico Alberici and Bo Baslund and Rajbir Batra and Denise Brown and Julia Holle and Zdenka Hruskova and Jayne, {David R W} and Andrew Judge and Little, {Mark A} and Alessandra Palmisano and Coen Stegeman and Vladimir Tesar and Augusto Vaglio and Kerstin Westman and Raashid Luqmani",

year = "2011",

month = may,

doi = "10.1093/rheumatology/keq400",

language = "English",

volume = "50",

pages = "899--905",

journal = "Rheumatology",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "5",

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Suppiah, R, Mukhtyar, C, Flossmann, O, Alberici, F, Baslund, B, Batra, R, Brown, D, Holle, J, Hruskova, Z, Jayne, DRW, Judge, A, Little, MA, Palmisano, A, Stegeman, C, Tesar, V, Vaglio, A, Westman, K & Luqmani, R 2011, 'A cross-sectional study of the Birmingham Vasculitis Activity Score version 3 in systemic vasculitis', Rheumatology, vol. 50, no. 5, pp. 899-905. https://doi.org/10.1093/rheumatology/keq400

TY - JOUR

T1 - A cross-sectional study of the Birmingham Vasculitis Activity Score version 3 in systemic vasculitis

AU - Suppiah, Ravi

AU - Mukhtyar, Chetan

AU - Flossmann, Oliver

AU - Alberici, Federico

AU - Baslund, Bo

AU - Batra, Rajbir

AU - Brown, Denise

AU - Holle, Julia

AU - Hruskova, Zdenka

AU - Jayne, David R W

AU - Judge, Andrew

AU - Little, Mark A

AU - Palmisano, Alessandra

AU - Stegeman, Coen

AU - Tesar, Vladimir

AU - Vaglio, Augusto

AU - Westman, Kerstin

AU - Luqmani, Raashid

PY - 2011/5

Y1 - 2011/5

N2 - OBJECTIVE: Assessment of disease activity in vasculitis can be achieved using the BVAS, a clinical checklist of relevant symptoms, signs and features of active disease. The aim of this study was to revalidate the BVAS version 3 (BVAS v. 3) in a cohort of patients with systemic vasculitis.METHODS: A total of 238 patients with vasculitis from seven countries in Europe were evaluated at a single time point. Spearman's correlation coefficients were calculated between BVAS v. 3 scores, vasculitis activity index (VAI), physician's global assessment (PGA), the physician's treatment decision, CRP and the vasculitis damage index (VDI) to demonstrate that the BVAS v. 3 measures disease activity.RESULTS: WG (63%), Churg-Strauss syndrome (9%) and microscopic polyangiitis (9%) were the most common diagnoses. The BVAS v. 3 showed convergent validity with the VAI [ρ = 0.82 (95% CI 0.77, 0.85)], PGA [ρ = 0.85 (95% CI 0.81, 0.88)] and the physician's treatment decision [ρ = 0.54 (95% CI 0.44, 0.62)]. There was little or no correlation between BVAS v. 3 and the CRP level [ρ = 0.18 (95% CI 0.05, 0.30)] or with the VDI [ρ = -0.10 (95% CI 0.22, 0.03)]. The inter-observer reliability was very high with an intra-class correlation coefficient (ICC) of 0.996 (95% CI 0.990, 0.998) for the total BVAS v. 3 score.CONCLUSION: The BVAS v. 3 has been evaluated in a large cohort of patients with vasculitis and the important properties of the tool revalidated. This study increases the utility of the BVAS v. 3 in different populations of patients with systemic vasculitis.

AB - OBJECTIVE: Assessment of disease activity in vasculitis can be achieved using the BVAS, a clinical checklist of relevant symptoms, signs and features of active disease. The aim of this study was to revalidate the BVAS version 3 (BVAS v. 3) in a cohort of patients with systemic vasculitis.METHODS: A total of 238 patients with vasculitis from seven countries in Europe were evaluated at a single time point. Spearman's correlation coefficients were calculated between BVAS v. 3 scores, vasculitis activity index (VAI), physician's global assessment (PGA), the physician's treatment decision, CRP and the vasculitis damage index (VDI) to demonstrate that the BVAS v. 3 measures disease activity.RESULTS: WG (63%), Churg-Strauss syndrome (9%) and microscopic polyangiitis (9%) were the most common diagnoses. The BVAS v. 3 showed convergent validity with the VAI [ρ = 0.82 (95% CI 0.77, 0.85)], PGA [ρ = 0.85 (95% CI 0.81, 0.88)] and the physician's treatment decision [ρ = 0.54 (95% CI 0.44, 0.62)]. There was little or no correlation between BVAS v. 3 and the CRP level [ρ = 0.18 (95% CI 0.05, 0.30)] or with the VDI [ρ = -0.10 (95% CI 0.22, 0.03)]. The inter-observer reliability was very high with an intra-class correlation coefficient (ICC) of 0.996 (95% CI 0.990, 0.998) for the total BVAS v. 3 score.CONCLUSION: The BVAS v. 3 has been evaluated in a large cohort of patients with vasculitis and the important properties of the tool revalidated. This study increases the utility of the BVAS v. 3 in different populations of patients with systemic vasculitis.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Churg-Strauss Syndrome/diagnosis

KW - Cohort Studies

KW - Cross-Sectional Studies

KW - Europe/epidemiology

KW - Female

KW - Granulomatosis with Polyangiitis/diagnosis

KW - Humans

KW - Male

KW - Microscopic Polyangiitis/diagnosis

KW - Middle Aged

KW - Observer Variation

KW - Reproducibility of Results

KW - Severity of Illness Index

KW - Systemic Vasculitis/classification

KW - Young Adult

U2 - 10.1093/rheumatology/keq400

DO - 10.1093/rheumatology/keq400

M3 - Article

C2 - 21156667

VL - 50

SP - 899

EP - 905

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 5

ER -