Brief index of lupus damage: A patient‐reported measure of damage in systemic lupus erythematosus

Abstract

Objectives: We sought to develop and test an interviewer-administered measure of damage in SLE, the Brief Index of Lupus Damage (BILD), for use in epidemiological studies in which administration of the SLICC/ACR Damage Index (SDI) by trained physicians is not possible or feasible. In addition, we compared the BILD to another recently developed patient-reported measure, the Lupus Damage Index Questionnaire (LDIQ), which was designed as a written survey. Methods: A sample of 81 patients from two university-affiliated SLE clinics was used to test the criterion validity of the BILD and the LDIQ. A second sample, the Lupus Outcomes Study (LOS, n=728) was used to ascertain the construct validity of the BILD. Results: We found good agreement between most BILD items and corresponding SDI items, and moderately high overall Spearman rank correlations for SDI with BILD (0.64 and with LDIQ (0.54). BILD scores were higher among older individuals, those with longer disease duration, and those with higher mean disease activity in the preceding four years. In addition, higher BILD scores were associated with poorer self-rated health and functional status, greater unemployment and work disability, and increased health care utilization. Conclusions: We developed and performed a preliminary validation study demonstrating content, criterion and construct validity of a new practical patient-reported instrument of SLE disease damage. Although further studies are needed to examine reliability and to document psychometric properties in other populations, the BILD appears to represent a promising tool for studies of SLE outside the clinical setting.

Validation and evaluation of the German Brief Index of Lupus Damage (BILD) – a self-reported instrument to record damage in systemic lupus erythematosus

“…We verified the high correlation of the BILD and SDI shown by Yazdani et al, representing criterion 10 we did not experience the significantly higher scoring of the patient- reported instrument that had been documented in both the validation studies of the LDIQ. 8,9 Possibly the extensive number of questions of the LDIQ must be held responsible and the reduced item number in the BILD helps avoid this patient bias by focusing on fewer relevant items.…”

“…angina/coronary artery bypass, osteoporosis and gonadal failure). 10 Especially the item 'gonadal failure' performed worse than the LDIQ or the BILD in the original paper, possibly because of comprehension problems of the translated item as we discovered some contradictory data in the patient information.…”

Developing new evaluation methods in systemic lupus erythematosus

“…A shorter questionnaire, the Brief Index of Lupus Damage (BILD), including only 26 items, has been more recently developed, demonstrating content, criterion and construct validity [29]. However, since its publication, the BILD was used only in few studies and it is not yet possible to draw any conclusion about its ability to capture chronic damage progression.…”

Clinical Composite Measures of Disease Activity and Damage Used to Evaluate Patients With Systemic Lupus Erythematosus: A Systematic Literature Review

“…49 Like LDIQ, it is completed by the patient but is a shorter version that includes only 28 questions. BILD criterion validity was examined through its correlation with other instrument that also measured damage, such as SDI, and can be considered as the gold standard (r=0.64, P<0.001).…”