BASDAI

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):

*Fatigue (medical)
*Spinal pain
*Joint pain or swelling
*Areas of localized tenderness (also called enthesitis, 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, infliximab and adalimumab, or may be eligible for enrollment in clinical trials evaluating new drug therapies directed at Ankylosing Spondylitis.

History

"Garrett and coworkers" writing in the [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=7699630 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 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.

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. [ [http://www.hlab27.com Asim Llc ] ] 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.

Tools and references

* [http://www.BASDAI.com BASDAI automated calculation tool]
* [http://www.hlab27.com/ HLAB27.com, M. Khan MD: Ankylosing Spondylitis]

References