title: Modification and validation of the Birmingham Vasculitis Activity Score (version 3).
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 r(s) = 0.66, 95% CI 0.59 to 0.72), BVAS1 of version 2 (r(s) = 0.94, 95% CI 0.92 to 0.96), BVAS2 of version 2 in patients with persistent disease (r(s) = 0.60, 95% CI 0.21 to 0.83), C-reactive protein levels (r(s) = 0.43, 95% CI 0.31 to 0.54), physician's global assessment (r(s) = 0.91, 95% CI 0.89 to 0.93) and vasculitis activity index (r(s) = 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Oxford, Oxford OX3 7LD, UK.
authors.forename: C
authors.initials: C
authors.lastname: Mukhtyar
authors.forename: R
authors.initials: R
authors.lastname: Lee
authors.forename: D
authors.initials: D
authors.lastname: Brown
authors.forename: D
authors.initials: D
authors.lastname: Carruthers
authors.forename: B
authors.initials: B
authors.lastname: Dasgupta
authors.forename: S
authors.initials: S
authors.lastname: Dubey
authors.forename: O
authors.initials: O
authors.lastname: Flossmann
authors.forename: C
authors.initials: C
authors.lastname: Hall
authors.forename: J
authors.initials: J
authors.lastname: Hollywood
authors.forename: D
authors.initials: D
authors.lastname: Jayne
authors.forename: R
authors.initials: R
authors.lastname: Jones
authors.forename: P
authors.initials: P
authors.lastname: Lanyon
authors.forename: A
authors.initials: A
authors.lastname: Muir
authors.forename: D
authors.initials: D
authors.lastname: Scott
authors.forename: L
authors.initials: L
authors.lastname: Young
authors.forename: R A
authors.initials: RA
authors.lastname: Luqmani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000175:diagnosis / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014657:Vasculitis / Q000175:diagnosis* / Q000188:drug therapy; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein