{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:07:25Z","timestamp":1777860445549,"version":"3.51.4"},"reference-count":26,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,6,8]],"date-time":"2020-06-08T00:00:00Z","timestamp":1591574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2020,6,21]]},"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec id=\"s1\">\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To develop and validate the evidence-based and consensus-based Beh\u00e7et\u2019s Syndrome Overall Damage Index (BODI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s2\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Starting from 120 literature-retrieved preliminary items, the BODI underwent multiple Delphi rounds with an international multidisciplinary panel consisting of rheumatologists, internists, ophthalmologists, neurologists, and patient delegates until consensus was reached on the final content. The BODI was validated in a cross-sectional multicentre cohort of 228 patients with Beh\u00e7et\u2019s syndrome (BS) through the study of (a) correlation between BODI and Vasculitis Damage Index (VDI) and (b) correlation between BODI and disease activity measures (ie, Beh\u00e7et\u2019s Disease Current Activity Form (BDCAF), Physician Global Assessment (PGA), Patient Global Assessment (PtGA)), c) content and face validity and (d) feasibility.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s3\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The final BODI consists of 4 overarching principles and 46 unweighted-items grouped into 9 organ domains. It showed good to excellent reliability, with a mean Cohen\u2019s k of 0.84 (95% CI 0.78 to 0.90) and a mean intra-class correlation coefficient of 0.88 (95% CI 0.80 to 0.95). Overall, 128 (56.1%) patients had a BODI score \u22651, with a median score of 1.0 (range 0\u201314). The BODI significantly correlated with the VDI (r=0.693, p&lt;0.001), demonstrating to effectively measure damage (construct validity), but had greater sensitivity in identifying major organ damage and did not correlate with disease activity measures (ie, BDCAF: p=0.807, PGA: p=0.820, PtGA: p=0.794) discriminating damage from the major confounding factor. The instrument was deemed credible (face validity), complete (content validity) and feasible by an independent group of clinicians.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s4\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Pending further validation, the BODI may be used to assess organ damage in patients with BS in the context of observational and controlled trials.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2020-001192","type":"journal-article","created":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T15:35:16Z","timestamp":1595518516000},"page":"e001192","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":39,"title":["Development and preliminary validation of the Beh\u00e7et\u2019s syndrome Overall Damage Index (BODI)"],"prefix":"10.1136","volume":"6","clinical-trial-number":[{"clinical-trial-number":"nct03803462","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1126-8315","authenticated-orcid":false,"given":"Matteo","family":"Piga","sequence":"first","affiliation":[{"name":"Rheumatology Unit, AOU University Clinic of Cagliari, Cagliari, Italy"}]},{"given":"Alberto","family":"Floris","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, AOU University Clinic of Cagliari, Cagliari, Italy"}]},{"given":"Gerard","family":"Espinosa","sequence":"additional","affiliation":[{"name":"Department of Autoimmune Diseases, Hospital Clinic, Institut d\u2019Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain"}]},{"given":"Lu\u00edsa","family":"Serpa Pinto","sequence":"additional","affiliation":[{"name":"Hospital Santo Antonio Centro Hospitalar Do Porto, Unidade De Imunologia Clinica, Porto, Portugal"}]},{"given":"Nikolaos","family":"Kougkas","sequence":"additional","affiliation":[{"name":"Rheumatology, Clinical Immunology and Allergy Unit, University of Crete, Heraklion, Greece"}]},{"given":"Andrea","family":"Lo Monaco","sequence":"additional","affiliation":[{"name":"Rheumatology Unit - AOU, S. Anna, Ferrara, University of Ferrara, Ferrara, Italy"}]},{"given":"Giuseppe","family":"Lopalco","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, University of Bari, Bari, Italy"}]},{"given":"Ida","family":"Orlando","sequence":"additional","affiliation":[{"name":"University of Siena, Rheumatology Unit, Siena, Italy"}]},{"given":"Vittorio","family":"Pirani","sequence":"additional","affiliation":[{"name":"Ophthalmology Clinic, Universit\u00e0 Politecnica Delle Marche, Ancona, Italy"}]},{"given":"Ernestina","family":"Santos","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Do Porto\/Hospital De Santo Ant\u00f3nio, Neurology Department, Porto, Portugal"},{"name":"UMIB Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, Portugal"}]},{"given":"George","family":"Bertsias","sequence":"additional","affiliation":[{"name":"Rheumatology, Clinical Immunology and Allergy Unit, University of Crete, Heraklion, Greece"}]},{"given":"Luca","family":"Cantarini","sequence":"additional","affiliation":[{"name":"University of Siena, Rheumatology Unit, Siena, Italy"}]},{"given":"Alberto","family":"Cauli","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, AOU University Clinic of Cagliari, Cagliari, Italy"}]},{"given":"Ricard","family":"Cervera","sequence":"additional","affiliation":[{"name":"Department of Autoimmune Diseases, Hospital Clinic, Institut d\u2019Investigacions Biomediques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain"}]},{"given":"Jo\u00e3o","family":"Correia","sequence":"additional","affiliation":[{"name":"Hospital Santo Antonio Centro Hospitalar Do Porto, Unidade De Imunologia Clinica, Porto, Portugal"}]},{"given":"Marcello","family":"Govoni","sequence":"additional","affiliation":[{"name":"Rheumatology Unit - AOU, S. Anna, Ferrara, University of Ferrara, Ferrara, Italy"}]},{"given":"Florenzo","family":"Iannone","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, University of Bari, Bari, Italy"}]},{"given":"Piergiorgio","family":"Neri","sequence":"additional","affiliation":[{"name":"Ophthalmology Clinic, Universit\u00e0 Politecnica Delle Marche, Ancona, Italy"},{"name":"Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates"}]},{"given":"Ana","family":"Martins Silva","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Do Porto\/Hospital De Santo Ant\u00f3nio, Neurology Department, Porto, Portugal"}]},{"given":"Carlos","family":"Vasconcelos","sequence":"additional","affiliation":[{"name":"UMIB Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, Portugal"}]},{"given":"Monica","family":"Muntoni","sequence":"additional","affiliation":[{"name":"Associazione Italiana Sindrome E Malattia Di Beh\u00e7et (SIMBA), Pontedera, Italy"}]},{"given":"Alessandro","family":"Mathieu","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, AOU University Clinic of Cagliari, Cagliari, Italy"}]}],"member":"239","published-online":{"date-parts":[[2020,7,23]]},"reference":[{"key":"2025090312150705000_6.2.e001192.1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1038\/nrrheum.2017.208","article-title":"Beh\u00e7et syndrome: a contemporary view","volume":"14","author":"Yazici","year":"2018","journal-title":"Nat Rev Rheumatol"},{"key":"2025090312150705000_6.2.e001192.2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq331"},{"key":"2025090312150705000_6.2.e001192.3","first-page":"S123","article-title":"The origin of Beh\u00e7et\u2019s disease geoepidemiology: possible role of a dual microbial-driven genetic selection","volume":"32","author":"Piga","year":"2014","journal-title":"Clin Exp Rheumatol"},{"key":"2025090312150705000_6.2.e001192.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199910213411707"},{"key":"2025090312150705000_6.2.e001192.5","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1136\/annrheumdis-2018-213225","article-title":"Update of the EULAR recommendations for the management of Beh\u00e7et\u2019s syndrome","volume":"2018","author":"Hatemi","year":"2018","journal-title":"Ann Rheum Dis"},{"key":"2025090312150705000_6.2.e001192.6","doi-asserted-by":"publisher","DOI":"10.1002\/art.27568"},{"key":"2025090312150705000_6.2.e001192.7","first-page":"1357","article-title":"The future of damage assessment in vasculitis","volume":"34","author":"Seo","year":"2007","journal-title":"J Rheumatol"},{"key":"2025090312150705000_6.2.e001192.8","first-page":"177","article-title":"Damage in the ANCA-associated vasculitides: long-term data from the European Vasculitis Study Group (EUVAS) therapeutic trials","volume":"335","author":"Robson","year":"1990","journal-title":"Ann Rheum Dis"},{"key":"2025090312150705000_6.2.e001192.9","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.161352"},{"key":"2025090312150705000_6.2.e001192.10","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.141147"},{"key":"2025090312150705000_6.2.e001192.11","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.131249"},{"key":"2025090312150705000_6.2.e001192.12","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400222"},{"key":"2025090312150705000_6.2.e001192.13","first-page":"i177","article-title":"Differences in early damage patterns in various forms of primary systemic vasculitis [abstract]","volume":"55","author":"Wawrzycka-Adamczyk","year":"2016","journal-title":"Rheumatology (Oxford)"},{"key":"2025090312150705000_6.2.e001192.14","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210092"},{"key":"2025090312150705000_6.2.e001192.15","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780390303"},{"key":"2025090312150705000_6.2.e001192.16","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.131310"},{"key":"2025090312150705000_6.2.e001192.17","first-page":"1078","article-title":"Criteria for diagnosis of Beh\u00e7et\u2019s disease. International study group for Beh\u00e7et\u2019s disease","volume":"335","year":"1990","journal-title":"Lancet"},{"key":"2025090312150705000_6.2.e001192.18","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12107"},{"key":"2025090312150705000_6.2.e001192.19","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/38.8.728"},{"key":"2025090312150705000_6.2.e001192.20","first-page":"S110","article-title":"Beh\u00e7et\u2019s syndrome patients have high levels of functional disability, fatigue and pain as measured by a Multi-Dimensional Health Assessment Questionnaire (MDHAQ)","volume":"26","author":"Moses Alder","year":"2008","journal-title":"Clin Exp Rheumatol"},{"key":"2025090312150705000_6.2.e001192.21","first-page":"S18","article-title":"Quality of life and its relation with disease severity in Beh\u00e7et\u2019s disease","volume":"27","author":"Ertam","year":"2009","journal-title":"Clin Exp Rheumatol"},{"key":"2025090312150705000_6.2.e001192.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.11.013"},{"key":"2025090312150705000_6.2.e001192.23","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.jbspin.2018.11.001","article-title":"The relapsing polychondritis damage index (RPDAM): development of a disease-specific damage score for relapsing polychondritis","volume":"86","author":"Mertz","year":"2019","journal-title":"Joint Bone Spine"},{"key":"2025090312150705000_6.2.e001192.24","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150985"},{"key":"2025090312150705000_6.2.e001192.25","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.100167"},{"key":"2025090312150705000_6.2.e001192.26","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-010-1430-6"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2020-001192","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:15:15Z","timestamp":1756926915000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2020-001192"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7]]},"references-count":26,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,7,23]]},"published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1136\/rmdopen-2020-001192"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2020-001192","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7]]}}}