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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. 1
    University of Oxford, Oxford, UK
  2. 2
    University of Edinburgh, Edinburgh, UK
  3. 3
    Birmingham City Hospital, Birmingham, UK
  4. 4
    Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK
  5. 5
    Norfolk and Norwich University Hospital Trust, Norwich, UK
  6. 6
    Addenbrooke’s Hospital, Cambridge, UK
  7. 7
    Nottingham University Hospitals NHS Trust, Nottingham, UK
  8. 8
    Royal 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}


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.

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  • ▸ Additional data are published online only at

  • 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.