Revised British Isles Lupus Assessment Group 2004 index: a reliable tool for assessment of systemic lupus erythematosus activity

Chee-Seng Yee, Vernon Farewell, David A Isenberg, Athiveeraramapandian Prabu, Katharina Sokoll, Lee-Suan Teh, Anisur Rahman, Ian N Bruce, Bridget Griffiths, Mohammed Akil, Neil McHugh, David D'Cruz, Munther A Khamashta, Simon Bowman, Peter Maddison, Asad Zoma, Elizabeth Allen, Caroline Gordon, British Isles Lupus Assessment Group

Research output: Contribution to journalArticle

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Abstract

Objective:
To test the interrater reliability of the revised British Isles Lupus Assessment Group 2004 (BILAG-2004) index for the assessment of systemic lupus erythematosus (SLE) activity.

Methods:
Patients with SLE were recruited from 11 centers. Two physician raters separately assessed the patients' disease activity using the BILAG-2004 index in routine clinical practice. Scores ranged from A (for very active disease) to E (for inactivity). Two reliability exercises were performed. Changes were made to the index after the first exercise (E1), and additional training was provided to the raters before the second exercise (E2). E1 and E2 involved 12 and 14 raters, respectively. Interrater reliability was assessed using kappa statistics and intraclass correlation coefficients. Levels of agreement and the extent of major disagreement were also examined. Major disagreement was defined as a score difference between raters of A versus C, D, or E or B versus D or E.

Results:
For each exercise, 97 patients were recruited. In E1, the mean age of the patients was 42.3 years (range 18.5–82.2 years), 89.7% were women, and 74.2% were white, 8.2% were Afro-Caribbean, and 13.4% were South Asian, and in E2, the mean age was 43.7 years (range 17.7–75 years), 90.7% were women, and 68% were white, 15.5% were Afro-Caribbean, and 11.3% were South Asian. The mean disease duration was 9.4 years (range 0–32.1 years) for patients in E1 and 10 years (range 0–34.8 years) in E2. There was improvement in the interrater reliability and the level of agreement from E1 to E2. Further improvement was achieved after removal of poorly performing items.

Conclusion:
The BILAG-2004 index is a reliable tool to assess SLE activity. The use of a well-defined glossary and training of raters are essential to ensure the optimal performance of the index.
Original languageEnglish
Pages (from-to)3300-3305
Number of pages6
JournalArthritis & Rheumatism
Volume54
Issue number10
Early online date27 Sep 2006
DOIs
Publication statusPublished - Oct 2006

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Systemic Lupus Erythematosus
Exercise
Physicians

Cite this

Yee, C-S., Farewell, V., Isenberg, D. A., Prabu, A., Sokoll, K., Teh, L-S., ... British Isles Lupus Assessment Group (2006). Revised British Isles Lupus Assessment Group 2004 index: a reliable tool for assessment of systemic lupus erythematosus activity. Arthritis & Rheumatism, 54(10), 3300-3305. https://doi.org/10.1002/art.22162

Revised British Isles Lupus Assessment Group 2004 index : a reliable tool for assessment of systemic lupus erythematosus activity. / Yee, Chee-Seng; Farewell, Vernon; Isenberg, David A; Prabu, Athiveeraramapandian; Sokoll, Katharina; Teh, Lee-Suan; Rahman, Anisur; Bruce, Ian N; Griffiths, Bridget; Akil, Mohammed; McHugh, Neil; D'Cruz, David; Khamashta, Munther A; Bowman, Simon; Maddison, Peter; Zoma, Asad; Allen, Elizabeth; Gordon, Caroline; British Isles Lupus Assessment Group.

In: Arthritis & Rheumatism, Vol. 54, No. 10, 10.2006, p. 3300-3305.

Research output: Contribution to journalArticle

Yee, C-S, Farewell, V, Isenberg, DA, Prabu, A, Sokoll, K, Teh, L-S, Rahman, A, Bruce, IN, Griffiths, B, Akil, M, McHugh, N, D'Cruz, D, Khamashta, MA, Bowman, S, Maddison, P, Zoma, A, Allen, E, Gordon, C & British Isles Lupus Assessment Group 2006, 'Revised British Isles Lupus Assessment Group 2004 index: a reliable tool for assessment of systemic lupus erythematosus activity', Arthritis & Rheumatism, vol. 54, no. 10, pp. 3300-3305. https://doi.org/10.1002/art.22162
Yee, Chee-Seng ; Farewell, Vernon ; Isenberg, David A ; Prabu, Athiveeraramapandian ; Sokoll, Katharina ; Teh, Lee-Suan ; Rahman, Anisur ; Bruce, Ian N ; Griffiths, Bridget ; Akil, Mohammed ; McHugh, Neil ; D'Cruz, David ; Khamashta, Munther A ; Bowman, Simon ; Maddison, Peter ; Zoma, Asad ; Allen, Elizabeth ; Gordon, Caroline ; British Isles Lupus Assessment Group. / Revised British Isles Lupus Assessment Group 2004 index : a reliable tool for assessment of systemic lupus erythematosus activity. In: Arthritis & Rheumatism. 2006 ; Vol. 54, No. 10. pp. 3300-3305.
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abstract = "Objective:To test the interrater reliability of the revised British Isles Lupus Assessment Group 2004 (BILAG-2004) index for the assessment of systemic lupus erythematosus (SLE) activity.Methods:Patients with SLE were recruited from 11 centers. Two physician raters separately assessed the patients' disease activity using the BILAG-2004 index in routine clinical practice. Scores ranged from A (for very active disease) to E (for inactivity). Two reliability exercises were performed. Changes were made to the index after the first exercise (E1), and additional training was provided to the raters before the second exercise (E2). E1 and E2 involved 12 and 14 raters, respectively. Interrater reliability was assessed using kappa statistics and intraclass correlation coefficients. Levels of agreement and the extent of major disagreement were also examined. Major disagreement was defined as a score difference between raters of A versus C, D, or E or B versus D or E.Results:For each exercise, 97 patients were recruited. In E1, the mean age of the patients was 42.3 years (range 18.5–82.2 years), 89.7{\%} were women, and 74.2{\%} were white, 8.2{\%} were Afro-Caribbean, and 13.4{\%} were South Asian, and in E2, the mean age was 43.7 years (range 17.7–75 years), 90.7{\%} were women, and 68{\%} were white, 15.5{\%} were Afro-Caribbean, and 11.3{\%} were South Asian. The mean disease duration was 9.4 years (range 0–32.1 years) for patients in E1 and 10 years (range 0–34.8 years) in E2. There was improvement in the interrater reliability and the level of agreement from E1 to E2. Further improvement was achieved after removal of poorly performing items.Conclusion:The BILAG-2004 index is a reliable tool to assess SLE activity. The use of a well-defined glossary and training of raters are essential to ensure the optimal performance of the index.",
author = "Chee-Seng Yee and Vernon Farewell and Isenberg, {David A} and Athiveeraramapandian Prabu and Katharina Sokoll and Lee-Suan Teh and Anisur Rahman and Bruce, {Ian N} and Bridget Griffiths and Mohammed Akil and Neil McHugh and David D'Cruz and Khamashta, {Munther A} and Simon Bowman and Peter Maddison and Asad Zoma and Elizabeth Allen and Caroline Gordon and {British Isles Lupus Assessment Group}",
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T1 - Revised British Isles Lupus Assessment Group 2004 index

T2 - a reliable tool for assessment of systemic lupus erythematosus activity

AU - Yee, Chee-Seng

AU - Farewell, Vernon

AU - Isenberg, David A

AU - Prabu, Athiveeraramapandian

AU - Sokoll, Katharina

AU - Teh, Lee-Suan

AU - Rahman, Anisur

AU - Bruce, Ian N

AU - Griffiths, Bridget

AU - Akil, Mohammed

AU - McHugh, Neil

AU - D'Cruz, David

AU - Khamashta, Munther A

AU - Bowman, Simon

AU - Maddison, Peter

AU - Zoma, Asad

AU - Allen, Elizabeth

AU - Gordon, Caroline

AU - British Isles Lupus Assessment Group

PY - 2006/10

Y1 - 2006/10

N2 - Objective:To test the interrater reliability of the revised British Isles Lupus Assessment Group 2004 (BILAG-2004) index for the assessment of systemic lupus erythematosus (SLE) activity.Methods:Patients with SLE were recruited from 11 centers. Two physician raters separately assessed the patients' disease activity using the BILAG-2004 index in routine clinical practice. Scores ranged from A (for very active disease) to E (for inactivity). Two reliability exercises were performed. Changes were made to the index after the first exercise (E1), and additional training was provided to the raters before the second exercise (E2). E1 and E2 involved 12 and 14 raters, respectively. Interrater reliability was assessed using kappa statistics and intraclass correlation coefficients. Levels of agreement and the extent of major disagreement were also examined. Major disagreement was defined as a score difference between raters of A versus C, D, or E or B versus D or E.Results:For each exercise, 97 patients were recruited. In E1, the mean age of the patients was 42.3 years (range 18.5–82.2 years), 89.7% were women, and 74.2% were white, 8.2% were Afro-Caribbean, and 13.4% were South Asian, and in E2, the mean age was 43.7 years (range 17.7–75 years), 90.7% were women, and 68% were white, 15.5% were Afro-Caribbean, and 11.3% were South Asian. The mean disease duration was 9.4 years (range 0–32.1 years) for patients in E1 and 10 years (range 0–34.8 years) in E2. There was improvement in the interrater reliability and the level of agreement from E1 to E2. Further improvement was achieved after removal of poorly performing items.Conclusion:The BILAG-2004 index is a reliable tool to assess SLE activity. The use of a well-defined glossary and training of raters are essential to ensure the optimal performance of the index.

AB - Objective:To test the interrater reliability of the revised British Isles Lupus Assessment Group 2004 (BILAG-2004) index for the assessment of systemic lupus erythematosus (SLE) activity.Methods:Patients with SLE were recruited from 11 centers. Two physician raters separately assessed the patients' disease activity using the BILAG-2004 index in routine clinical practice. Scores ranged from A (for very active disease) to E (for inactivity). Two reliability exercises were performed. Changes were made to the index after the first exercise (E1), and additional training was provided to the raters before the second exercise (E2). E1 and E2 involved 12 and 14 raters, respectively. Interrater reliability was assessed using kappa statistics and intraclass correlation coefficients. Levels of agreement and the extent of major disagreement were also examined. Major disagreement was defined as a score difference between raters of A versus C, D, or E or B versus D or E.Results:For each exercise, 97 patients were recruited. In E1, the mean age of the patients was 42.3 years (range 18.5–82.2 years), 89.7% were women, and 74.2% were white, 8.2% were Afro-Caribbean, and 13.4% were South Asian, and in E2, the mean age was 43.7 years (range 17.7–75 years), 90.7% were women, and 68% were white, 15.5% were Afro-Caribbean, and 11.3% were South Asian. The mean disease duration was 9.4 years (range 0–32.1 years) for patients in E1 and 10 years (range 0–34.8 years) in E2. There was improvement in the interrater reliability and the level of agreement from E1 to E2. Further improvement was achieved after removal of poorly performing items.Conclusion:The BILAG-2004 index is a reliable tool to assess SLE activity. The use of a well-defined glossary and training of raters are essential to ensure the optimal performance of the index.

UR - http://dx.doi.org/10.1002/art.22162

U2 - 10.1002/art.22162

DO - 10.1002/art.22162

M3 - Article

C2 - 17009266

VL - 54

SP - 3300

EP - 3305

JO - Arthritis & Rheumatism

JF - Arthritis & Rheumatism

SN - 0004-3591

IS - 10

ER -