Revised British isles lupus assessment group 2004 index - A reliable tool for assessment of systemic lupus erythematosus activity
Revised British isles lupus assessment group 2004 index - A reliable tool for assessment of systemic lupus erythematosus activity
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DOI：
10.1002/art.22162
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发表时间：
2006-10-01
影响因子：
--
通讯作者：
Gordon, Caroline
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文献类型：
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作者：
Yee, Chee-Seng;Farewell, Vernon;Gordon, Caroline
客观的。测试修订后的不列颠群岛狼疮评估组 2004 (BILAG-2004) 指数用于评估系统性红斑狼疮 (SLE) 活动的受试者间可靠性。方法。从 11 个中心招募 SLE 患者。两名医师评估员在常规临床实践中使用 BILAG-2004 指数分别评估患者的疾病活动度。分数范围从 A（表示疾病非常活跃）到 E（表示不活动）。进行了两次可靠性练习。第一次练习（E1）后对指数进行了更改，并在第二次练习（E2）之前向评估者提供了额外的培训。 E1 和 E2 分别涉及 12 名和 14 名评估者。使用 kappa 统计数据和组内相关系数评估评估者间的可靠性。还审查了一致程度和主要分歧的程度。主要分歧定义为 A 与 C、D 或 E 或 B 与 D 或 E 评分者之间的分数差异。 结果。每次演习招募了 97 名患者。在E1中，患者的平均年龄为42.3岁（范围18.5-82.2岁），89.7％为女性，74.2％为白人，8.2％为加勒比非洲裔，13.4％为南亚人；在E2中，平均年龄为43.7岁（范围17.7-75岁），90.7％为女性， 68% 是白人，15.5% 是非裔加勒比人，11.3% 是南亚人。 E1 患者的平均病程为 9.4 年（范围 0-32.1 年），E2 患者的平均病程为 10 年（范围 0-34.8 年）。从 El 到 E2，评估者间的可靠性和一致性水平有所提高。删除表现不佳的项目后，取得了进一步的改进。结论。 BILAG-2004 指数是评估 SLE 活动的可靠工具。使用明确定义的术语表和培训评估者对于确保指数的最佳性能至关重要。
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 El 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.