Clinical Activity and Quality of Life Indices Are Valid Across Ulcerative Colitis But Not Crohn’s Disease Phenotypes

Taleban, Sasha; Stewart, Kathleen O.; Li, Darrick K.; Singh, Prashant; Pardi, Darrell S.; Sturgeon, Holly C.; Yajnik, Vijay; Xavier, Ramnik J.; Ananthakrishnan, Ashwin N.; Khalili, Hamed

doi:10.1007/s10620-016-4180-8

Cited by 18 publications

(15 citation statements)

References 46 publications

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“…The best correlation was obtained for the Baron et al 18 score with left-sided colitis (SF, 0.503, P < .05; RB, 0.723, P < .001; and Seo et al 1 index, 0.688, P < .001). Taleban et al 35 consistently found a superior correlation between SCCAI and endoscopic disease activity in UC with left-sided disease compared with patients with extensive colitis (r ¼ 0.73 vs 0.45; P ¼ .005) (Supplementary Table 1).…”

Section: Association Between Clinical Symptoms and Endoscopy In The Dmentioning

confidence: 86%

“…Active vs inactive disease. Overall, 8 studies only included patients with active disease (Lewis et al, 19 Dhanda et al, 20 Jharap et al, 21 Scaioli et al, 23 Seo et al, 3 Achitei et al, 24 Mirpour et al, 25 Jairath et al 1 ), whereas 15 studies included patients with both active and inactive disease (Bodelier et al, 26 Schoepfer et al, 27 Pagnini et al, 28 Beattie et al, 7 Azzolini et al, 12 Hirai et al, 29 Langhorst et al, 30 Arai et al, 31 Higging et al, 32 Ricanek et al, 33 Samuel et al, 34 Taleban et al, 35 Falvey et al, 36 Chen et al, 37 and Colombel et al 22 ). Unfortunately, the published data do not provide information for active vs inactive disease separately.…”

Section: Association Between Clinical Symptoms and Endoscopy In The Dmentioning

confidence: 99%

“…Four studies (Dhanda et al, 20 Jharap et al, 21 Beattie et al, 7 and Scaioli et al 2015) excluded patients with proctitis only. Only 2 studies specifically analyzed the correlation of clinical indices and endoscopic activity between various disease localizations (Seo et al 3 and Taleban et al 35 ). In Seo et al 3 the Spearman correlation between clinical indices and the Baron et al 18 index for combined locations was 0.352 (P < .001) for SF, 0.624 (P < .001) for RB, and 0.688 (P < .001) for the Seo et al 3 index.…”

Section: Association Between Clinical Symptoms and Endoscopy In The Dmentioning

confidence: 99%

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Clinical Parameters Correlate With Endoscopic Activity of Ulcerative Colitis: A Systematic Review

Restellini

Chen

Martel

et al. 2019

Clinical Gastroenterology and Hepatology

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BACKGROUND & AIMS: Optimal management of patients with ulcerative colitis (UC) requires assessment of disease activity-usually by endoscopy, which is invasive, costly, and not risk free. We performed a systematic review to determine whether clinical symptoms correlate with findings from endoscopy assessments of patients with UC. METHODS: We performed a systematic review of publication databases from January 1980 through July 2018 to identify clinical trials and observational studies reporting correlations among symptoms, disease activity index scores and/or patient reported outcomes (rectal bleeding and/or stool frequency), and endoscopic disease activity. Correlations were ascertained in patients with active vs inactive disease and by disease extent and treatment type. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Because of significant heterogeneity, meta-analysis was not possible. Results were synthesized qualitatively and systematically. RESULTS: Our final analysis included 23 studies (1 randomized trial, 22 observational studies) comprising 3320 patients with UC. The studies used a variety of measures to assess clinical activity, endoscopic activity, and measures of correlation (sensitivity, specificity, correlation coefficients, area under the receiver operator curve). Overall, studies were at moderate-high risk of bias. Composite clinical measures, including rectal bleeding and stool frequency, had moderate to strong correlations with endoscopic disease activity; the absence of rectal bleeding identified patients with inactive disease with higher levels of sensitivity than normalization of stool frequency. In general, symptoms correlated more strongly with endoscopic activity in patients with left-sided colitis than extensive colitis. The effect of different medications on the correlation between clinical and endoscopic activity has not been well studied. CONCLUSIONS: In a systematic review, we found a moderate to strong correlation between clinical activity, particularly the combination of rectal bleeding and stool frequency, and endoscopic activity in patients with UC. Although these clinical assessments could help prioritize patients for endoscopic evaluation in resource-limited settings, challenges associated with treating patients based on symptoms alone preclude adaptation of current management algorithms.

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Section: Association Between Clinical Symptoms and Endoscopy In The Dmentioning

confidence: 86%

Section: Association Between Clinical Symptoms and Endoscopy In The Dmentioning

confidence: 99%

Section: Association Between Clinical Symptoms and Endoscopy In The Dmentioning

confidence: 99%

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Clinical Parameters Correlate With Endoscopic Activity of Ulcerative Colitis: A Systematic Review

Restellini

Chen

Martel

et al. 2019

Clinical Gastroenterology and Hepatology

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“…This is an ongoing prospective cohort of adult patients diagnosed with CD, UC, or IBD-unspecified (IBDU) receiving care at the Massachusetts General Hospital Crohn’s and Colitis center 22–25 . Upon obtaining informed consent, a detailed questionnaire assessing disease and treatment related information was completed by interview with a trained clinical research coordinator and confirmed by review of the medical records.…”

Section: Methodsmentioning

confidence: 99%

Older Age- and Health-related Quality of Life in Inflammatory Bowel Diseases

Velonias

Conway

Andrews

et al. 2017

Inflammatory Bowel Diseases

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Introduction The burden of inflammatory bowel disease (IBD) in the older population is increasing. Older-onset disease is associated with reduced use of immunosuppressive medications. In addition, older patients may be more vulnerable to the effect of disease-related symptoms, and consequently may experience worse health-related quality of life (HRQoL) compared to younger patients. Methods This prospective study included a cohort of patients with Crohn’s disease (CD) and ulcerative colitis (UC) recruited from a single center. All patients completed the short inflammatory bowel disease questionnaire (SIBDQ) and the short form-12 questionnaire (SF-12) yielding general physical (PCS) and mental component scale subscores (MCS). Patients older than age 60 years were compared to those younger than age 60 using multivariable regression analysis. Results Our study included 1,607 patients, among whom 186 were older than age 60 at the time of assessment. Older patients were more likely to have isolated colonic disease and less likely to use immunosuppressive therapy. On multivariable analysis, older IBD patients had higher SIBDQ (2.34, 95% confidence interval (CI) 0.82 – 3.87) and SF12 mental subscores (3.78, 95% CI 2.26 – 5.30) but lower physical HRQoL (−1.80, 95% CI −3.21 to −0.38). There was no difference in the SIBDQ and PCS scores between older patients with newly diagnosed IBD or with established disease. Conclusion Older age was associated with modestly higher SIBDQ and mental HRQoL but lower physical HRQoL. Comprehensive care of the older IBD patient should include assessment of factors impairing physical quality of life to ensure appropriate interventions.

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“…Compared to Crohn"s Disease (CD) symptom-based disease activity indices correlate fairly well with endoscopic and biometric grading of activity 1,2,3, 4 …”

mentioning

confidence: 99%

Simple Clinical Colitis Activity Index (SCCAI) and future patient-centered telemedical care of Ulcerative Colitis patients

Walmsley

Roy

2017

MRAJ

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Clinical Activity and Quality of Life Indices Are Valid Across Ulcerative Colitis But Not Crohn’s Disease Phenotypes

Cited by 18 publications

References 46 publications

Clinical Parameters Correlate With Endoscopic Activity of Ulcerative Colitis: A Systematic Review

Clinical Parameters Correlate With Endoscopic Activity of Ulcerative Colitis: A Systematic Review

Older Age- and Health-related Quality of Life in Inflammatory Bowel Diseases

Simple Clinical Colitis Activity Index (SCCAI) and future patient-centered telemedical care of Ulcerative Colitis patients

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