Article Text

Download PDFPDF
Extended report
Modification and validation of the Birmingham Vasculitis Activity Score (version 3)
  1. C Mukhtyar1,
  2. R Lee2,
  3. D Brown1,
  4. D Carruthers3,
  5. B Dasgupta4,
  6. S Dubey5,
  7. O Flossmann6,
  8. C Hall2,
  9. J Hollywood4,
  10. D Jayne6,
  11. R Jones6,
  12. P Lanyon7,
  13. A Muir7,
  14. D Scott5,
  15. L Young8,
  16. R A Luqmani1,2
  1. 1University of Oxford, Oxford, UK
  2. 2University of Edinburgh, Edinburgh, UK
  3. 3Birmingham City Hospital, Birmingham, UK
  4. 4Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK
  5. 5Norfolk and Norwich University Hospital Trust, Norwich, UK
  6. 6Addenbrooke’s Hospital, Cambridge, UK
  7. 7Nottingham University Hospitals NHS Trust, Nottingham, UK
  8. 8Royal Berkshire NHS Foundation Trust, Reading, UK
  1. Correspondence to Dr R A Luqmani, Botnar Research Centre, University of Oxford, Windmill Road, Oxford OX3 7LD, UK; raashid.luqmani{at}ndos.ox.ac.uk

Abstract

Background: Comprehensive multisystem clinical assessment using the Birmingham Vasculitis Activity score (BVAS) is widely used in therapeutic studies of systemic vasculitis. Extensive use suggested a need to revise the instrument. The previous version of BVAS has been revised, according to usage and reviewed by an expert committee.

Objective: To modify and validate version 3 of the BVAS in patients with systemic vasculitis.

Methods: The new version of BVAS was tested in a prospective cross-sectional study of patients with vasculitis.

Results: The number of items was reduced from 66 to 56. The subscores for new/worse disease and persistent disease were unified. In 313 patients with systemic vasculitis, BVAS(v.3) correlated with treatment decision (Spearman’s rs = 0.66, 95% CI 0.59 to 0.72), BVAS1 of version 2 (rs = 0.94, 95% CI 0.92 to 0.96), BVAS2 of version 2 in patients with persistent disease (rs = 0.60, 95% CI 0.21 to 0.83), C-reactive protein levels (rs = 0.43, 95% CI 0.31 to 0.54), physician’s global assessment (rs = 0.91, 95% CI 0.89 to 0.93) and vasculitis activity index (rs = 0.88, 95% CI 0.86 to 0.91). The intraclass correlation coefficients for reproducibility and repeatability were 0.96 (95% CI 0.95 to 0.97) and 0.96 (95% CI 0.92 to 0.97), respectively. In 39 patients assessed at diagnosis and again at 3 months, the BVAS(v.3) fell by 17 (95% CI 15 to 19) units (p<0.001, paired t test).

Conclusion: BVAS(v.3) demonstrates convergence with BVAS(v.2), treatment decision, physician global assessment of disease activity, vasculitis activity index and C-reactive protein. It is repeatable, reproducible and sensitive to change. The new version of BVAS is validated for assessment of systemic vasculitis.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • ▸ Additional data are published online only at http://ard.bmj.com/content/vol68/issue12

  • Funding This study was funded by a grant from the Arthritis Research Campaign (project grant 16031). CM is funded by a project grant from the European League Against Rheumatism.

  • Competing interests None.

  • Ethics approval Approval from the multicentre research ethics committee.