BASDAI: Bath Ankylosing Spondylitis Disease Activity Index

Disease activity in ankylosing spondylitis. Free to use.

rheumatology 6 items Updated 2026-05-06

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What is BASDAI? BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) is a validated instrument used to assess disease activity in ankylosing spondylitis. It comprises 6 items.

What is BASDAI?

BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) is a validated clinical instrument used to assess disease activity in ankylosing spondylitis. The instrument contains 6 items.

Source / attribution: Garrett S et al. J Rheumatol. 1994;21(12):2286-2291.

Clinical context: when BASDAI is used

The instrument's primary construct — disease activity in ankylosing spondylitis — is operationalized through a fixed set of items, each with a defined response format. This standardisation is what allows BASDAI scores to be compared meaningfully across clinicians, sites, and studies.

Like all screening or assessment instruments, BASDAI is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.

Score BASDAI

Answer all 6 items below to see your BASDAI score and interpretation.

All scoring runs in your browser. No data is sent anywhere — close the tab and the answers are gone.

How BASDAI is scored

BASDAI uses a published formula (basdai) rather than simple summation. The formula and its inputs are visible in our open-source scoring engine.

Scoring notes: BASDAI = (q1 + q2 + q3 + q4 + (q5 + q6) / 2) / 5; range 0–10.

BASDAI score interpretation

The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.

Score rangeBandInterpretation
0–3.9Inactive diseaseDisease activity below the conventional 4.0 cutoff.
4–10Active disease≥ 4.0 indicates active disease; consider treatment intensification.

How to score BASDAI: worked example

BASDAI uses a published formula rather than simple summation. Below is a step-by-step calculation with illustrative inputs.

Step 1 — Collect the inputs

InputValue
Q1–Q4each = 5
Q55
Q65

Step 2 — Apply the formula

  1. Score Q1–Q4 each on 0–10.
  2. Score Q5 (morning stiffness severity) and Q6 (morning stiffness duration) each on 0–10.
  3. BASDAI = (Q1 + Q2 + Q3 + Q4 + (Q5 + Q6)/2) / 5 = (5 + 5 + 5 + 5 + (5+5)/2) / 5 = 5.0

Step 3 — Read the result

Score = 5Active disease

Use the calculator above with your own values →

Limitations & common pitfalls

How BASDAI compares to other rheumatology scales

If BASDAI doesn't fit your context, related instruments in rheumatology include:

ScaleMeasuresItemsTime
BASFIFunctional limitation in ankylosing spondylitis10
ODISelf-reported low-back-pain functional disability10
NDISelf-reported neck-pain functional disability10
Oxford Knee ScorePain and function after total knee replacement12
Oxford Hip ScorePain and function after total hip replacement12
LEFSFunction with lower-extremity musculoskeletal disorders20
IPSSLower-urinary-tract symptoms in men7
IIEF-5 / SHIMErectile dysfunction screen5

Frequently asked questions about BASDAI

What does BASDAI measure?

BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) is a validated instrument that assesses disease activity in ankylosing spondylitis.

How many items are on BASDAI?

BASDAI contains 6 items.

What is a high BASDAI score?

Scores of 4–10 fall in the "Active disease" band. ≥ 4.0 indicates active disease; consider treatment intensification.

What is a low BASDAI score?

Scores of 0–3.9 fall in the "Inactive disease" band. Disease activity below the conventional 4.0 cutoff.

Is BASDAI free to use?

Yes — BASDAI is in the public domain and free for clinical, educational, and research use without permission.

What is the source paper for BASDAI?

Garrett S et al. A new approach to defining disease status in ankylosing spondylitis. J Rheumatol. 1994;21(12):2286-2291.

Can BASDAI replace clinical judgment?

No. BASDAI is a structured assessment aid. A score is one input alongside history, examination, and clinical context. Treatment decisions should never rest on a screening score alone.

References & validation

BASDAI is supported by the following peer-reviewed sources: