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Development of an Arabic version of the Behçet’s Disease Current Activity Form (Ar-BDCAF): cross-cultural adaptation and validation initiative in Egypt

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Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Background

Behçet’s disease (BD), commonly seen in the Silk road countries, is a variable vessel vasculitis with no specific investigation that reflects disease activity. The Behçet’s Disease Current Activity Form (BDCAF) is the most famous and acceptable clinical activity score.

Purpose

To develop a cross-cultural adaptation of the BDCAF to the Arabic language (Ar-BDCAF)—Egyptian dialect—across the country and to consider preliminary evaluation of its reliability in assessment of BD activity.

Patients and methods

The score was translated to Arabic language and revised by 3 rheumatology consultants. Reliability of Ar-BDCAF was tested among 88 BD patients from 9 Egyptian main city centers. Patients were questioned by two specialists at 30 min interval to evaluate inter-observer rating and twice by the same physician within 24 h to assess the intra-observer rating.

Results

Patients were 64 males and 24 females (2.7:1) with a mean age of 35 ± 10.3 years. The average time required by the consultant to fill in the form was 5.1 ± 2.2 min (1.5–15 min). The mean Ar-BDCAF scores were 9.81 ± 6.22 (0–25) and 9.53 ± 6.13 (0–28) with an intra-observer concordance (p = 0.28) and was 9.95 ± 6.47 (0–29) for the inter-observer rating (p = 0.89 and p = 0.66, respectively).

Conclusion

The Ar-BDCAF is a measurable, easy to calculate, and reliable index for assessing disease activity in Egyptian BD. The Ar-BDCAF score can be used in daily clinical practice to assess BD activity and its use can be extended to other Arab countries for possible regional validation and adaptations.

Key Points

• The Arabic version of the BDCAF can be extended to other Arab countries for development of a Pan-Arab score.

• This is the first study to provide a reliable and valid Arabic version of the BDCAF-Egyptian dialect for measuring current disease activity in BD patients.

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Data availability

An availability of all datasets used and/or analyzed during this study was granted with raw data available on asking on private bases and will be available on open request.

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Acknowledgements

The authors would like to acknowledge the professors of rheumatology and internal medicine for their support to the Egyptian College of Rheumatology (ECR) study groups. Thank you to the following ECR study group—Behçet’s Disease collaborators: Abdel Hafeez Moshrif: Rheumatology Department, Faculty of Medicine, Al-Azhar University, Assuit, Egypt. Ahmed Elsaman: Rheumatology Department, Faculty of Medicine, Sohag University, Egypt. Amany R El-Najjar: Rheumatology Department, Faculty of Medicine, Zagazig University, Egypt. Amira Al Shanawany: Rheumatology Department, Faculty of Medicine, Menoufiya University, Egypt. Dina Elessawi: Rheumatology Unit Internal Medicine Department, Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt. Ehab Saad: Rheumatology Department, Faculty of Medicine, South Valley University, Egypt. Eiman M Abd El-Latif: Ophthalmology Department, Faculty of Medicine, Alexandria University, Egypt. Eman F Mohamed: Rheumatology Unit, Internal Medicine Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. Faten Ismail: Rheumatology Department, Faculty of Medicine, Minia University, Egypt. Hanan M El-Saadany: Rheumatology Department, Faculty of Medicine, Tanta University, Egypt. Hala Raafat: Rheumatology Department, Faculty of Medicine, Cairo University, Egypt. Hossam M Khalil: Ophthalmology Department, Faculty of Medicine, Beni-Suef University, Egypt. Iman El-Gazzar: Rheumatology Department, Faculty of Medicine, Cairo University, Egypt. Marwa ElKhalifa: Internal Medicine Rheumatology Unit, Faculty of Medicine, Alexandria University, Egypt. Mervat I Abd Elazeem: Rheumatology Department, Faculty of Medicine, Beni-Suef University, Egypt. Nermeen Noshy: Internal Medicine Rheumatology Unit, Faculty of Medicine, Ain-Shams University, Cairo, Egypt. Noha M Khalil: Internal Medicine Rheumatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt. Rehab Sallam: Rheumatology Department, Faculty of Medicine, Mansoura University, Egypt. Samar Fawzy: Rheumatology Department, Faculty of Medicine, Cairo University, Egypt. Soha E Ibrahim: Rheumatology Department, Faculty of Medicine, Ain Shams University, Egypt. Soha Senara: Rheumatology Department, Faculty of Medicine, Fayoum University, Egypt. Yousra Hisham: Rheumatology Department, Faculty of Medicine Alexandria University, Egypt.

Thanks are also to the following assistant lecturers and senior residents of Rheumatology and Internal Medicine from Egyptian universities for their aid in fulfilling the form: Heba E. Tolba; Manar Ragab (Fayoum), Sara Farrag; Asmaa Nabil (Assuit); Faten M. Khalifa; Asmaa A. El- Banhawy (Benha), Asmaa K. Mohamed; Reem M. Gad (Minia); Sahar Younis; Marwa M. Taha (Cairo), Samar Medhat; Noura Ghareeb; Amira Radwan; Fatma Abdelnasser; Eman Elsayed (Tanta), Enas Zahran; Shymaa Daif (Menoufia); Ahmed Ramadan; Ali Abdou (Mansoura), Osama M. Hussein; Shahenaz H. El Genedi (Beni Suef). Thanks to Mrs. Bahia O. Abdel-Aziz (former Arabic Language expert – Ministry of Higher Education) for revising the Arabic translation.

Author information

Authors and Affiliations

  1. Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

    Tamer A. Gheita & Nahla N. Eesa

  2. Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt

    Hanan M. Fathi

  3. Internal Medicine Department, Rheumatology Unit, Menoufia University, Menoufia, Egypt

    Emad El-Shebini

  4. Rheumatology and Immunology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Samar Tharwat

  5. Division of Rheumatology, Department of Medicine, University of California, San Francisco, CA, USA

    Nevin Hammam

  6. Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt

    Nevin Hammam & Mona H. Abd El-Samea

  7. Rheumatology Department, Faculty of Medicine, Benha University, Benha, Egypt

    Rasha M. Fawzy

  8. Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt

    Rawhya R. El-Shereef

  9. Internal Medicine Department, Rheumatology Unit, Tanta University, Gharbia, Egypt

    Rasha A. Abdel Noor

  10. Internal Medicine Department, Rheumatology Immunology Division, Beni-Suef University, Beni-Suef, Egypt

    Mohamed N. Salem

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  1. Tamer A. Gheita
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Consortia

on behalf of the Egyptian College of Rheumatology Study Group

  • Abdel Hafeez Moshrif
  • , Ahmed Elsaman
  • , Amany R. El-Najjar
  • , Amira Al Shanawany
  • , Dina Elessawi
  • , Ehab Saad
  • , Eiman M. Abd El-Latif
  • , Eman F. Mohamed
  • , Faten Ismail
  • , Hanan M. El-Saadany
  • , Hala Raafat
  • , Hossam M. Khalil
  • , Iman El-Gazzar
  • , Marwa ElKhalifa
  • , Mervat I. Abd Elazeem
  • , Nermeen Noshy
  • , Noha M. Khalil
  • , Rehab Sallam
  • , Samar Fawzy
  • , Soha E. Ibrahim
  • , Soha Senara
  •  & Yousra Hisham

Corresponding author

Correspondence to Tamer A. Gheita.

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Ethics approval

The study had been approved from the local ethical committee of the participating centers.

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An informed consent was obtained from patients with detailed explanation about the study and aim.

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All authors have previously given their agreement for publication of the article with an agreement form to the Clinical Rheumatology Journal.

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Gheita, T.A., Fathi, H.M., Eesa, N.N. et al. Development of an Arabic version of the Behçet’s Disease Current Activity Form (Ar-BDCAF): cross-cultural adaptation and validation initiative in Egypt. Clin Rheumatol 40, 4609–4618 (2021). https://doi.org/10.1007/s10067-021-05817-1

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