Numerical scoring for the Classic BILAG index

Lynne Cresswell, Chee Seng Yee, Vernon Farewell, Anisur Rahman, Lee Suan Teh, Bridget Griffiths, Ian N. Bruce, Yasmeen Ahmad, Athiveeraramapandian Prabu, Mohammed Akil, Neil McHugh, Veronica Toescu, David D'Cruz, Munther A. Khamashta, Peter Maddison, David A. Isenberg, Caroline Gordon

    Research output: Contribution to journalArticlepeer-review


    Objective. To develop an additive numerical scoring scheme for the Classic BILAG index. Methods. SLE patients were recruited into this multi-centre cross-sectional study. At every assessment, data were collected on disease activity and therapy. Logistic regression was used to model an increase in therapy, as an indicator of active disease, by the Classic BILAG score in eight systems. As both indicate inactivity, scores of D and E were set to 0 and used as the baseline in the fitted model. The coefficients from the fitted model were used to determine the numerical values for Grades A, B and C. Different scoring schemes were then compared using receiver operating characteristic (ROC) curves. Validation analysis was performed using assessments from a single centre. Results. There were 1510 assessments from 369 SLE patients. The currently used coding scheme (A=9, B=3, C=1 and D/E=0) did not fit the data well. The regression model suggested three possible numerical scoring schemes: (i) A=11, B=6, C=1 and D/E=0; (ii) A=12, B=6, C=1 and D/ E=0; and (iii) A=11, B=7, C=1 and D/E=0. These schemes produced comparable ROC curves. Based on this, A=12, B=6, C=1 and D/E=0 seemed a reasonable and practical choice. The validation analysis suggested that although the A=12, B=6, C=1 and D/E=0 coding is still reasonable, a scheme with slightly less weighting for B, such as A=12, B=5, C=1 and D/ E=0, may be more appropriate. Conclusions. A reasonable additive numerical scoring scheme based on treatment decision for the Classic BILAG index is A=12, B=5, C=1, D=0 and E=0. © The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.
    Original languageEnglish
    Pages (from-to)1548-1552
    Number of pages4
    Issue number12
    Publication statusPublished - 2009


    • BILAG
    • Disease activity
    • Global score
    • Outcome measures
    • Regression model
    • SLE
    • Statistics
    • Treatment decision


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