Journal List > J Rheum Dis > v.23(1) > 1064264

Choi, Seo, Ryu, and Baek: Behçet's Disease Current Activity Form as a Patient's Derived Measure

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).

Conclusion

The BDCAF appears useful as a patient self-report instrument for assessment of disease status.

REFERENCES

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Table 1.
Demographic and clinical characteristics of study patients
Characteristic Physician-derived BDCAF (n=63) Patient-derived BDCAF (n=53)
Age (yr) 47.7±11.0 47.5±11.0
Sex (M:F) 17:46 14:39
Disease duration (yr) 5.3±4.9 4.9±4.8
Clinical symptoms    
 Oral ulcer 63 (100.0) 53 (100.0)
 Genital ulcer 40 (63.5) 32 (60.4)
 Skin lesions 41 (65.1) 36 (67.9)
Organ involvement    
 Eye 12 (19.0) 10 (18.9)
 Vascular 5 (7.9) 5 (9.4)
 Joints 24 (38.1) 18 (34.0)
 Gastrointestinal 7 (11.1) 5 (9.4)
 Central nervous system 5 (7.9) 5 (9.4)
Medication patterns and dose (mg)    
 Colchicine 40 (1.3±0.4) 34 (1.3±0.4)
 NSAIDs 18 (689.7±384.8) 16 (743.8±363.3)
 Steroids 33 (9.8±9.7) 27 (10.1±10.3)
Immunosuppresants    
 Azathioprine 6 (91.7±20.4) 5 (100.0±0.0)
 Methotrexate 7 (12.9±3.7) 7 (12.9±3.7)
 Sulfasalazine 5 (1,300.0±670.8) 3 (1,166.7±763.8)
 Hydroxychloroquine 4 (350.0±100.0) 4 (350.0±100.0)
Patient's VAS 3.9±1.8 4.1±1.7
Physician's VAS 4.1±1.5  
BDCAF score (transformed) 6.3±3.2 6.0±3.2
BDQOL score 8.6±7.7 8.7±8.4
ESR (mm/h) 14.9±15.7  
CRP (mg/dL) 0.6±2.1  

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.
The agreement between physician and patient derived questionnaires of Behçet's Disease Current Activity Form
Item Kappa p-value
Headache 0.883 <0.001
Oral ulceration 0.775 <0.001
Genital ulceration 0.797 <0.001
Erythema 0.651 <0.001
Skin pustules 0.588 <0.001
Joints– arthralgia 0.586 <0.001
Joints– arthritis 0.652 <0.001
Nausea/vomiting/abdominal pain 0.332 0.005
Diarrhea with altered/frank blood per rectum 0.737 <0.001
Eye involvement 0.511 <0.001
Nervous system involvement 0.291 0.033
Major vessel involvement 0.291 0.033
Table 3.
Spearman's correlation coefficient between BDCAF score and other variables
  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*

BDCAF: Behçet's Disease Current Activity Form, BDQOL: Behçet's Disease Quality of Life, VAS: visual analogue scale (1 to 7).

* p<0.05.

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