title: The BILAG2004-Pregnancy index is reliable for assessment of disease activity in pregnant SLE patients.
abstract: OBJECTIVE
  To assess the inter-rater reliability of the BILAG2004-Pregnancy index for assessment of SLE disease activity in pregnancy.
  
  
  METHODS
  Pregnant SLE patients were recruited from four centres and assessed separately by two raters/physicians in routine clinical practice. Disease activity was determined using the BILAG2004-Pregnancy index. Reliability was assessed using level of agreement, κ-statistics and analysis of disagreement. Major disagreement was defined as a score difference of A and C/D/E or B and D/E between the two raters, and minor disagreement was a score difference of A and B or B and C between raters.
  
  
  RESULTS
  A total of 30 patients (63.3% Caucasian, 13.3% Afro-Caribbean, 16.7% South Asian) were recruited. The majority of patients had low-level disease activity according to the local rater's assessment, and there was no grade A activity, with grade B activity present in the following systems: mucocutaneous (nine patients), musculoskeletal (two patients), cardiorespiratory (one patient) and renal (one patient). The distribution of disease activity was similar to the external rater's assessment. Good levels of agreement (>70%) were achieved in all systems. κ-statistics were not appropriate for use in the gastrointestinal, ophthalmic, constitutional and neuropsychiatric systems, as there was minimal variation between patients but good levels of agreement otherwise. There were three major disagreements (0.1 per patient, all differences between B and D/E) and five minor disagreements (0.17 per patient).
  
  
  CONCLUSIONS
  The BILAG2004-Pregnancy index is reliable for assessment of disease activity in pregnant SLE patients.
authors: Department of Rheumatology, Doncaster Royal Infirmary, Armthorpe Road, Doncaster DN2 5LT, UK. csyee@ymail.com
authors: Chee-Seng
authors: CS
authors: Yee
authors: Mohammed
authors: M
authors: Akil
authors: Munther
authors: M
authors: Khamashta
authors: Rupa
authors: R
authors: Bessant
authors: Rachael
authors: R
authors: Kilding
authors: Ian
authors: I
authors: Giles
authors: Vernon T
authors: VT
authors: Farewell
authors: Caroline
authors: C
authors: Gordon
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D015203:Reproducibility of Results; D012720:Severity of Illness Index