BASDAI
Encyclopedia
The BASDAI is important because it is a validated diagnostic test which allows a physician (usually a rheumatologist) to determine the effectiveness of a current drug therapy, or the need to institute a new drug therapy for the treatment of ankylosing spondylitis
. The BASDAI consists of a one through 10 scale measuring discomfort, pain, and fatigue (one being no problem and 10 being the worst problem) in response to 6 questions pertaining to the 5 major symptoms of Ankylosing Spondylitis (AS):
To give each symptom equal weighting, the average of the two scores relating to morning stiffness is taken. The resulting 0 to 50 score is divided by 5 to give a final 0 – 10 BASDAI score. Scores of 4 or greater suggest suboptimal control of disease, and patients with scores of 4 or greater are usually good candidates for either a change in their medical therapy, eligible for treatment with powerful biologic therapies such as etanercept
, infliximab
and adalimumab
, or may be eligible for enrollment in clinical trials evaluating new drug therapies directed at Ankylosing Spondylitis.
(AS). This validated tool is the BASDAI, or the Bath Ankylosing Spondylitis Disease Activity Index. A research team consisting of rheumatologists, physiotherapists, and research associates with a special interest in AS developed the index in Bath, England
, hence the reason for "Bath" in the name.
BASDAI demonstrated statistically significant (p<0.001) reliability.
BASDAI encorporates a reasonable scale. The individual symptoms and the index as a whole demonstrated good score distribution, using 95% of the scale.
BASDAI demonstrates a sensitivity to change within a short period of time. Following a 3 week physiotherapy course, the BASDAI showed a significant (p=0.009) 16.4% score improvement.
Because the BASDAI reflects ongoing inflammatory disease, patients with advanced or "burned out" disease may score well on the test despite their advanced disease. Another test was developed for this purpose, the Bath Ankylosing Spondylitis Functional Index or BASFI
test, and this test reflects functional limitations in patients with more advanced disease.
Ankylosing spondylitis
Ankylosing spondylitis , previously known as Bekhterev's disease, Bekhterev syndrome, and Marie-Strümpell disease is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and nonarticular structures...
. The BASDAI consists of a one through 10 scale measuring discomfort, pain, and fatigue (one being no problem and 10 being the worst problem) in response to 6 questions pertaining to the 5 major symptoms of Ankylosing Spondylitis (AS):
- Fatigue (medical)
- Spinal pain
- Joint pain or swelling
- Areas of localized tenderness (also called enthesitisEnthesitisEnthesitis is inflammation of the entheses, the sites where tendons or ligaments insert into the bone. It is also called enthesopathy, or any pathologic condition involving the entheses. The entheses are any point of attachment of skeletal muscles to the bone, where recurring stress or...
, or inflammation of tendons and ligaments) - Morning stiffness duration
- Morning stiffness severity
To give each symptom equal weighting, the average of the two scores relating to morning stiffness is taken. The resulting 0 to 50 score is divided by 5 to give a final 0 – 10 BASDAI score. Scores of 4 or greater suggest suboptimal control of disease, and patients with scores of 4 or greater are usually good candidates for either a change in their medical therapy, eligible for treatment with powerful biologic therapies such as etanercept
Etanercept
Etanercept is a drug that treats autoimmune diseases by interfering with the tumor necrosis factor by acting as a TNF inhibitor. Pfizer describes in a SEC filing that the drug is used to treat rheumatoid, juvenile rheumatoid and psoriatic arthritis, plaque psoriasis and ankylosing spondylitis...
, infliximab
Infliximab
Infliximab is a monoclonal antibody against tumour necrosis factor alpha . It is used to treat autoimmune diseases. Remicade is marketed by Janssen Biotech, Inc...
and adalimumab
Adalimumab
Adalimumab is the third TNF inhibitor, after infliximab and etanercept, to be approved in the United States. Like infliximab and etanercept, adalimumab binds to TNFα, preventing it from activating TNF receptors; adalimumab was constructed from a fully human monoclonal antibody, while infliximab...
, or may be eligible for enrollment in clinical trials evaluating new drug therapies directed at Ankylosing Spondylitis.
History
Garrett and coworkers writing in the Journal of Rheumatology in December 1994 described a self-administered 6-question measurement tool which was to become the gold standard for measuring and evaluating disease activity in Ankylosing SpondylitisAnkylosing spondylitis
Ankylosing spondylitis , previously known as Bekhterev's disease, Bekhterev syndrome, and Marie-Strümpell disease is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and nonarticular structures...
(AS). This validated tool is the BASDAI, or the Bath Ankylosing Spondylitis Disease Activity Index. A research team consisting of rheumatologists, physiotherapists, and research associates with a special interest in AS developed the index in Bath, England
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
, hence the reason for "Bath" in the name.
Validation
BASDAI is a quick and simple index (taking between 30 secs and 2 mins to complete: see test link below)BASDAI demonstrated statistically significant (p<0.001) reliability.
BASDAI encorporates a reasonable scale. The individual symptoms and the index as a whole demonstrated good score distribution, using 95% of the scale.
BASDAI demonstrates a sensitivity to change within a short period of time. Following a 3 week physiotherapy course, the BASDAI showed a significant (p=0.009) 16.4% score improvement.
Because the BASDAI reflects ongoing inflammatory disease, patients with advanced or "burned out" disease may score well on the test despite their advanced disease. Another test was developed for this purpose, the Bath Ankylosing Spondylitis Functional Index or BASFI
BASFI
The Bath Ankylosing Spondylitis Functional Index was named for the location of the institution where authors G. Calin and co-workers developed this validated index to determine the degree of functional limitation in patients with the inflammatory autoimmune disease Ankylosing Spondylitis...
test, and this test reflects functional limitations in patients with more advanced disease.