The BILAG2004-Pregnancy index is reliable for assessment of disease activity in pregnant SLE patients
Yee CS et al. – The BILAG2004–Pregnancy index is reliable for assessment of disease activity in pregnant SLE patients.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.
- 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).