Document Detail

Validation of the ulcerative colitis colonoscopic index of severity and its correlation with disease activity measures.
MedLine Citation:
PMID:  22902762     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: Endoscopic healing is likely to become an important goal for treatment of patients with ulcerative colitis (UC). A simple validated endoscopic index is needed. We validated the previously developed UC Colonoscopic Index of Severity (UCCIS).
METHODS: In a prospective study, 50 patients with UC were examined by colonoscopy; we analyzed videos of rectum and sigmoid, descending, transverse, and cecum/ascending colon. Eight gastroenterologists blindly rated 4 mucosal lesions (for vascular pattern, granularity, friability, ulceration) and severity of damage to each segment and overall. The global assessment of endoscopic severity (GAES) was based on a 4-point scale and 10-cm visual analogue scale. Correlation of the UCCIS score with clinical indexes (clinical activity index and simple clinical colitis activity index), patient-defined remission, and laboratory measures of disease activity (levels of C-reactive protein, albumin, and hemoglobin and platelet counts) were estimated by using the Pearson (r) or Spearman (r(s)) method.
RESULTS: Interobserver agreement was good to excellent for the 4 mucosal lesions evaluated by endoscopy and the GAES. The UCCIS calculated for our data accounted for 74% (R(2) = 0.74) and 80% (R(2) = 0.80) of the variation in the GAES and visual analogue scores, respectively (P < .0001). The UCCIS also correlated with clinical activity index (r = 0.52, P < .001), simple clinical colitis activity index (r = 0.62, P < .0001), and patient-defined remission (r = 0.43, P < .01). The UCCIS also correlated with levels of C-reactive protein (r(s) = 0.56, P < .001), albumin (r = -0.55, P < .001), and hemoglobin (r = -0.39, P < .01). A rederivation of the equation for the UCCIS by using the data from a previous study combined with those of the current study (n = 101) yielded similar results.
CONCLUSIONS: The UCCIS is a simple tool that provides reproducible results in endoscopic scoring of patients with UC.
Sunil Samuel; David H Bruining; Edward V Loftus; Kelvin T Thia; Kenneth W Schroeder; William J Tremaine; William A Faubion; Sunanda V Kane; Darrell S Pardi; Piet C de Groen; William S Harmsen; Alan R Zinsmeister; William J Sandborn
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2012-08-16
Journal Detail:
Title:  Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association     Volume:  11     ISSN:  1542-7714     ISO Abbreviation:  Clin. Gastroenterol. Hepatol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-18     Completed Date:  2013-05-23     Revised Date:  2013-12-19    
Medline Journal Info:
Nlm Unique ID:  101160775     Medline TA:  Clin Gastroenterol Hepatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  49-54.e1     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Colitis, Ulcerative / diagnosis*,  pathology*
Colonoscopy / methods*
Middle Aged
Prospective Studies
Severity of Illness Index*
Young Adult
Grant Support
Comment In:
Clin Gastroenterol Hepatol. 2013 Jan;11(1):55-6   [PMID:  23022700 ]

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