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Easy-BILAG: a new tool for simplified recording of SLE disease activity using BILAG-2004 index

OBJECTIVE: BILAG-2004 index is a comprehensive disease activity instrument for SLE but administrative burden and potential frequency of errors limits its use in routine practice. We aimed to develop a tool for more accurate, time-efficient scoring of BILAG-2004 index with full fidelity to the existi...

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Autores principales: Carter, Lucy M, Gordon, Caroline, Yee, Chee-Seng, Bruce, Ian, Isenberg, David, Skeoch, Sarah, Vital, Edward M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536795/
https://www.ncbi.nlm.nih.gov/pubmed/35077529
http://dx.doi.org/10.1093/rheumatology/keab883
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author Carter, Lucy M
Gordon, Caroline
Yee, Chee-Seng
Bruce, Ian
Isenberg, David
Skeoch, Sarah
Vital, Edward M
author_facet Carter, Lucy M
Gordon, Caroline
Yee, Chee-Seng
Bruce, Ian
Isenberg, David
Skeoch, Sarah
Vital, Edward M
author_sort Carter, Lucy M
collection PubMed
description OBJECTIVE: BILAG-2004 index is a comprehensive disease activity instrument for SLE but administrative burden and potential frequency of errors limits its use in routine practice. We aimed to develop a tool for more accurate, time-efficient scoring of BILAG-2004 index with full fidelity to the existing instrument. METHODS: Frequency of BILAG-2004 items was collated from a BILAG-biologics registry (BILAG-BR) dataset. Easy-BILAG prototypes were developed to address known issues affecting speed and accuracy. After expert verification, accuracy and usability of the finalized Easy-BILAG was validated against standard format BILAG-2004 in a workbook exercise of 10 case vignettes. Thirty-three professionals ranging in expertise from 14 UK centres completed the validation exercise. RESULTS: Easy-BILAG incorporates all items present in ≥5% BILAG-BR records, plus full constitutional and renal domains into a rapid single page assessment. An embedded glossary and colour-coding assists domain scoring. A second page captures rarer manifestations when needed. In the validation exercise, Easy-BILAG yielded higher median scoring accuracy (96.7%) than standard BILAG-2004 documentation (87.8%, P = 0.001), with better inter-rater agreement. Easy-BILAG was completed faster (59.5 min) than the standard format (80.0 min, P = 0.04) for 10 cases. An advantage in accuracy was observed with Easy-BILAG use among general hospital rheumatologists (91.3 vs 75.0, P = 0.02), leading to equivalent accuracy as tertiary centre rheumatologists. Clinicians rated Easy-BILAG as intuitive, convenient, and well adapted for routine practice. CONCLUSION: Easy-BILAG facilitates more rapid and accurate scoring of BILAG-2004 across all clinical settings, which could improve patient care and biologics prescribing. Easy-BILAG should be adopted wherever BILAG-2004 assessment is required.
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spelling pubmed-95367952022-10-07 Easy-BILAG: a new tool for simplified recording of SLE disease activity using BILAG-2004 index Carter, Lucy M Gordon, Caroline Yee, Chee-Seng Bruce, Ian Isenberg, David Skeoch, Sarah Vital, Edward M Rheumatology (Oxford) Clinical Science OBJECTIVE: BILAG-2004 index is a comprehensive disease activity instrument for SLE but administrative burden and potential frequency of errors limits its use in routine practice. We aimed to develop a tool for more accurate, time-efficient scoring of BILAG-2004 index with full fidelity to the existing instrument. METHODS: Frequency of BILAG-2004 items was collated from a BILAG-biologics registry (BILAG-BR) dataset. Easy-BILAG prototypes were developed to address known issues affecting speed and accuracy. After expert verification, accuracy and usability of the finalized Easy-BILAG was validated against standard format BILAG-2004 in a workbook exercise of 10 case vignettes. Thirty-three professionals ranging in expertise from 14 UK centres completed the validation exercise. RESULTS: Easy-BILAG incorporates all items present in ≥5% BILAG-BR records, plus full constitutional and renal domains into a rapid single page assessment. An embedded glossary and colour-coding assists domain scoring. A second page captures rarer manifestations when needed. In the validation exercise, Easy-BILAG yielded higher median scoring accuracy (96.7%) than standard BILAG-2004 documentation (87.8%, P = 0.001), with better inter-rater agreement. Easy-BILAG was completed faster (59.5 min) than the standard format (80.0 min, P = 0.04) for 10 cases. An advantage in accuracy was observed with Easy-BILAG use among general hospital rheumatologists (91.3 vs 75.0, P = 0.02), leading to equivalent accuracy as tertiary centre rheumatologists. Clinicians rated Easy-BILAG as intuitive, convenient, and well adapted for routine practice. CONCLUSION: Easy-BILAG facilitates more rapid and accurate scoring of BILAG-2004 across all clinical settings, which could improve patient care and biologics prescribing. Easy-BILAG should be adopted wherever BILAG-2004 assessment is required. Oxford University Press 2022-01-25 /pmc/articles/PMC9536795/ /pubmed/35077529 http://dx.doi.org/10.1093/rheumatology/keab883 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Clinical Science
Carter, Lucy M
Gordon, Caroline
Yee, Chee-Seng
Bruce, Ian
Isenberg, David
Skeoch, Sarah
Vital, Edward M
Easy-BILAG: a new tool for simplified recording of SLE disease activity using BILAG-2004 index
title Easy-BILAG: a new tool for simplified recording of SLE disease activity using BILAG-2004 index
title_full Easy-BILAG: a new tool for simplified recording of SLE disease activity using BILAG-2004 index
title_fullStr Easy-BILAG: a new tool for simplified recording of SLE disease activity using BILAG-2004 index
title_full_unstemmed Easy-BILAG: a new tool for simplified recording of SLE disease activity using BILAG-2004 index
title_short Easy-BILAG: a new tool for simplified recording of SLE disease activity using BILAG-2004 index
title_sort easy-bilag: a new tool for simplified recording of sle disease activity using bilag-2004 index
topic Clinical Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9536795/
https://www.ncbi.nlm.nih.gov/pubmed/35077529
http://dx.doi.org/10.1093/rheumatology/keab883
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