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

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.