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Validity of a vasculitis activity index for systemic necrotizing vasculitis
Q E Whiting-O'Keefe1, J H Stone, D B Hellmann
1University of California, San Francisco, USA.
Arthritis and Rheumatism
|November 11, 1999
Summary
The Vasculitis Activity Index (VAI) is a valid tool for measuring systemic necrotizing vasculitis (SNV) activity. It shows high correlation with physician assessment and is sensitive to changes over time.
Area of Science:
- Rheumatology
- Clinical Measurement
- Systemic Necrotizing Vasculitis (SNV)
Background:
- Systemic necrotizing vasculitis (SNV) requires accurate disease activity measurement for effective management.
- Existing methods for assessing SNV activity may have limitations in terms of objectivity and sensitivity.
Purpose of the Study:
- To establish the validity and reliability of the Vasculitis Activity Index (VAI) as a measure of disease activity in SNV.
- To compare the VAI with the Physician's Global Assessment (PGA) as a gold standard.
Main Methods:
- The Vasculitis Activity Index (VAI) was developed using weighted clinical measurements across 9 organ systems and 3 indirect measures.
- Validation involved two datasets: a questionnaire-based set from 100 rheumatologists and a clinical set from 74 patients with SNV.
- Data were collected using 0-4 visual analog scales, with Physician's Global Assessment (PGA) as the benchmark.
Main Results:
- The VAI demonstrated high correlation with PGA in both datasets (R=0.84 and R=0.92).
- The VAI exhibited significantly lower interobserver variation compared to PGA (P=0.002).
- Changes in VAI over time strongly correlated with changes in PGA (R=0.88), indicating sensitivity to change.
Conclusions:
- The Vasculitis Activity Index (VAI) is a valid and reliable tool for assessing disease activity in SNV.
- The VAI offers advantages over PGA due to reduced interobserver variability and high sensitivity to clinical changes.
- Further validation studies for the VAI are recommended.
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