{
  "abstract": "Objectives Guidelines for SLE and prescribing guidelines for high-cost drugs require assessing disease activity with validated instruments. Oweing to the complexity of the disease, these instruments have either lacked detail or been complex to use. BILAG-2004 is the most comprehensive instrument but has been considered too challenging to score in routine clinical settings, without extensive training and experience. We developed Digital-BILAG—a streamlined web/mobile implementation integrated with electronic notes—and conducted an initial validation study to test whether it improves speed, accuracy, and user satisfaction versus paper BILAG-2004, with implications for both routine care and clinical trials.Methods Specialist lupus clinicians as well as rheumatologists inexperienced with BILAG scored identical sets of simple (S1–S4) and complex (C1–C4) simulated cases using paper BILAG-2004 and Digital-BILAG. Time-to-completion and accuracy of item/domain/overall grades were recorded against model answers. Paired comparisons of completion times used Wilcoxon signed-rank tests (and paired t-tests where appropriate); accuracy distributions used chi-square tests, and differences in overall ‘completely correct’ rates used a two-proportion z-test. User experience was captured by a 10-item Likert questionnaire (0–5). A 2×2 multipanel figure (timing, domain radar, accuracy) accompanies this abstract.Results For simple cases Digital-BILAG reduced time from 3.7 to 1.9 minutes (1.8 min faster, 47.5% reduction, Wilcoxon p=0.016). For complex cases mean time reduced from 6.9 to 3.4 minutes (3.5 min faster, 50.9% reduction). Despite their lack of training and experience, error rates by inexperienced users were as low as experienced users for the digital BILAG. Most strikingly, in usability data, Digital BILAG showed markedly higher user ratings across all items assessed ( figure 1).Abstract PT7:07 Figure 1Conclusions Digital-BILAG allows rapid application of BILAG-2004 within clinic appointments with minimal training: it accelerates scoring, maintains or improves accuracy, and enhances user satisfaction compared with paper BILAG-2004. By operationalising BILAG rules and guiding users step-by-step, it closes longstanding fluency gaps that necessitate adjudication, offering auditable, shareable outputs that fit naturally into clinical workflows. Ongoing work will further explore the value of Digital BILAG in a wider range of users and scenarios. These features support global multi-centre adoption and more consistent data capture in clinical trials, with potential to reduce adjudication costs, improve data quality, and strengthen endpoint reliability—key barriers implicated in prior SLE trial failures.",
  "authors": [
    {
      "affiliations": [
        "Leeds Institute of Rheumatic and Musculoskeletal Disease, University of Leeds, Leeds, UK"
      ],
      "name": "Jack Arnold"
    },
    {
      "affiliations": [
        "Leeds Institute of Rheumatic and Musculoskeletal Disease, University of Leeds, Leeds, UK"
      ],
      "name": "Bhavika Sethi"
    },
    {
      "affiliations": [
        "Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK"
      ],
      "name": "Lucy Marie Carter"
    },
    {
      "affiliations": [
        "Leeds Institute of Rheumatic and Musculoskeletal Disease, University of Leeds, Leeds, UK"
      ],
      "name": "Edward Vital"
    }
  ],
  "title": "PT7:07 Digital-BILAG: making BILAG-2004 practical for routine care and clinical trial use",
  "uid": "e3b756d8-272a-5863-8e05-7d49aac7fff5"
}