Development and initial validation of the vasculitis damage index for the standardized clinical assessment of damage in the systemic vasculitides

Abstract

Objective. To develop and validate the VasculitisDamage Index (VDI) for the standardized clinical assessment of damage in the systemic vasculitides.Methods. Using a nominal group consensus approach, the Birmingham Vasculitis Group generated guiding principles for assessment of damage in all systemic vasculitides. Damage was defined as irreversible change resulting from scars. Consensus principles were developed into the VDI, including guidelines for use, a list of items of damage, and a glossary.Results. For 100 surviving patients with systemic vasculitis, the median VDI score at last observation was 3 (range 0-8). Within the Wegener's granulomatosis subgroup, the median VDI score for 12 non-survivors was higher than for 47 survivors (non-survivors median score 7, interquartile range 5-8 versus survivors median score 4, interquartile range 2-5; P = 0.003). VDI scores for 100 patients with systemic vasculitis increased from initial presentation to last observation by a median score of 3 (range 1-4; P C 0.001). The VDI assesses more items and is more sensitive to change than other indices of damage (P < 0.001). Using the VDI, trained observers can produce moderately consistent damage scores. Conclusion. The VDI is a sensitive, reproducible, comprehensive, and credible clinical tool for quantifying damage.

Macrophage Migration Inhibitory Factor (MIF) and Thyroid Hormone Alterations in Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis (AAV)

“…Disease activity was assessed using BVAS (20), chronic damage was assessed using Vasculitis Damage Index (VDI) (21). The dose of GC was calculated in prednisolone equivalent mg and the total amount given up to each timepoint noted along with the prescribed dose on sampling day.…”

Pregnancy in women diagnosed with Antineutrophil cytoplasmic antibody–associated vasculitis: Outcome for the mother and the child

“…Disease activity at diagnosis was scored using the Birmingham Vasculitis Activity Score (BVAS) (18). Damage due to vasculitis presence at the time of conception was scored by the Vasculitis Damage Index (VDI) (19). Birth weight was expressed as median birth weight in grams and percentiles for singleton Dutch newborns with adjustment for sex and parity (20), and for twin newborns with adjustment for race (21).…”

Severity-based treatment for Japanese patients with MPO-ANCA-associated vasculitis: the JMAAV study

“…BVAS was scored at every visit. The vasculitis damage index (VDI) [12] was scored at entry and then once every 6 months for 18 months. The Short-Form 36 functional questionnaire (SF-36) was also assessed at entry and then once every 6 months for 18 months.…”