IOIBD report no 1: Observer variation in calculating indices of severity and activity in Crohn's disease. International Organisation for the Study of Inflammatory Bowel Disease.

Plasma Osteopontin Predicts Inflammatory Bowel Disease Activities

“…The clinical activities of the patients with UC were determined using the clinical activity index (CAI) and ulcerative colitis activity index (UCAI). 15,16 For the patients with CD, Crohn's disease activity index (CDAI) 17 and the index of inflammatory bowel disease (IOIBD) 18 were determined. The ethics committee of Nihon University Nerima Hikarigaoka Hospital approved the study protocol.…”

Infliximabe na doença de crohn: experiência clínica de um centro terciário paulista

“…A primeira delas refere-se à variação existente entre os resultados de avaliações efetuadas por diferentes avaliadores (21) ; a segunda diz respeito à falta de objetividade de variáveis como intensidade da dor e sentimento de bem-estar geral, intimamente dependentes das percepções do paciente em relação à própria doença e do limiar de dor; essa subjetividade também parece estar ligada aos casos em que pacientes tomando placebo apresentam índices elevados de melhora em alguns ensaios clínicos (22) . Além disso, a necessidade de o paciente registrar diariamente algumas variáveis por sete dias também dificulta a larga utilização desse índice na prática clínica comum.…”

Use of the Crohn’s disease activity index in clinical trials of biological agents

“…The CDAI appeared to be relatively reliable if used by these observers well experienced in its application. However, significant inter-observer differences were later noted in a series of separate studies, published as a single paper [17] . In one study, the CDAI was calculated from 10 "paper cases" evaluated by 5 consultants in surgery or gastroenterology, and 2 research assistants.…”

“…Third, some symptoms may be difficult to interpret or quantitate easily. For example, "liquid" stools may be difficult to precisely define [17] . Finally, even though enterocutaneous fistulae may be very troublesome for the patient, their impact on the CDAI may be limited.…”