Abstract
Objective
This study measured the reliability of the Behçet's Disease Current Activity Form (BDCAF) questionnaire used as a patient self-report form.
Methods
A study was conducted among 63 patients with Behçet's disease who attended our rheumatology clinic. First, a physician administered a BDCAF questionnaire. Second, the patient completed a self-administered questionnaire at home within 24 hours of the visit. The test– retest reliability was analyzed using kappa tests. Kappa scores of >0.6 indicated good agreement. The BDCAF score was compared with the patient's/clinician's perception of disease activity and the Korean version of Behçet's Disease Quality of Life (BDQOL).
Results
The study included 17 males and 46 females. The mean age of participants was 47.7 years and the mean disease duration was 5.3 years at the first assessment. Fifty-three patients (84.1%) returned the questionnaires to us by mail. For test– retest reliability, good agreement was achieved with the items including headache, oral/genital ulceration, erythema, arthritis, and diarrhea with altered/frank blood per rectum; moderate agreement with skin pustules, arthralgia, and eye involvement; fair agreement with nausea/vomiting/abdominal pain, nervous system, and major vessel involvement. Significant associations were observed between BDCAF scores with the patient's/clinician's perception of disease activity and BDQOL (p<0.05).
REFERENCES
2. Alpsoy E, Zouboulis CC, Ehrlich GE. Mucocutaneous lesions of Behçet's disease. Yonsei Med J. 2007; 48:573–85.
3. Choi HJ, Seo MR, Ryu HJ, Baek HJ. Cross-cultural adaptation and validation of the Behçet's Disease Current Activity Form in Korea. Korean J Intern Med. 2015; 30:714–8.
4. Bhakta BB, Brennan P, James TE, Chamberlain MA, Noble BA, Silman AJ. Behçet's disease: evaluation of a new instrument to measure clinical activity. Rheumatology (Oxford). 1999; 38:728–33.
5. Hatemi G, Merkel PA, Hamuryudan V, Boers M, Direskeneli H, Aydin SZ, et al. Outcome measures used in clinical trials for Behçet syndrome: a systematic review. J Rheumatol. 2014; 41:599–612.
6. Forbess C, Swearningen C, Yazici Y. Behçet's syndrome activity score (BSAS): a new disease activity assessment tool, composed of patient derived measures only, is strongly correlated with the Behçet's disease current activity form (BDCAF). Arthritis Rheum. 2008; 58(Suppl 9):S854.
7. Houssien DA, Stucki G, Scott DL. A patient-derived disease activity score can substitute for a physician-derived disease activity score in clinical research. Rheumatology (Oxford). 1999; 38:48–52.
8. Pincus T, Sokka T. Complexities in the quantitative assessment of patients with rheumatic diseases in clinical trials and clinical care. Clin Exp Rheumatol. 2005; 23(5 Suppl 39):S1–9.
9. International Study Group for Behçet's Disease. Criteria for diagnosis of Behçet's disease. Lancet. 1990; 335:1078–80.
10. Chang HK, Kim SY. Survey and validation of the criteria for Behçet's disease recently used in Korea: a suggestion for modification of the International Study Group criteria. J Korean Med Sci. 2003; 18:88–92.
11. Yi SW, Kim JH, Lim KY, Bang D, Lee S, Lee ES. The Behçet's Disease Quality of Life: reliability and validity of the Korean version. Yonsei Med J. 2008; 49:698–704.
12. Pincus T. Why should rheumatologists collect patient selfreport questionnaires in routine rheumatologic care? Rheum Dis Clin North Am. 1995; 21:271–319.
13. Hamuryudan V, Fresko I, Direskeneli H, Tenant MJ, Yurdakul S, Akoglu T, et al. Evaluation of the Turkish translation of a disease activity form for Behçet's syndrome. Rheumatology (Oxford). 1999; 38:734–6.
14. Neves FS, Moraes JC, Kowalski SC, Goldenstein-Schainberg C, Lage LV, Gonçalves CR. Cross-cultural adaptation of the Behçet's Disease Current Activity Form (BDCAF) to Brazilian Portuguese language. Clin Rheumatol. 2007; 26:1263–7.
15. Choi HJ, Seo MR, Ryu HJ, Baek HJ. Validation and reliability of a Behçet's Syndrome Activity Scale in Korea. Korean J Intern Med. 2016; 31:170–5.
Table 1.
Values are presented as mean±SD, number only, number (%), or number (mean±SD). NSAIDs included six different drugs. Dose of methylprednisolone was converted to equivalent prednisolone dose. BDCAF: Behçet's Disease Current Activity Form, BDQOL: Behçet's Disease Quality of Life, CRP: C-reactive protein, ESR: erythrocyte sedimentation rate, F: female, M: male, NSAIDs: non-steroidal anti-inflammatory drugs, SD: standard deviation, VAS: visual analogue scale (1 to 7).
Table 2.
Table 3.
Correlation coefficient | Evaluator | Physician-derived BDCAF | Patient-derived BDCAF |
---|---|---|---|
BDCAF score (transformed) | By physician | 0.829* | |
By patient | 0.829* | ||
Patient's VAS | By physician | 0.391* | |
By patient | 0.472* | ||
Physician's VAS | By physician | 0.366* | |
By patient | |||
BDQOL score | By physician | 0.506* | |
By patient | 0.389* |