Background: Several tools exist to assess disease activity in patients with UC. The Simple Clinical Colitis Activity Index (SCCAI; Walmsley RS et al. Gut 1998;43:29–32) is a validated symptom based index (score 0–19) which has a good correlation with more complicated disease activity indices. However the score which defines a relapse has not been determined.

Aims: To determine a) the validity of the SCCAI when self-administered, b) the score that defines a relapse c) the correlation with existing disease activity indices.

Method: UC patients routinely attending hospital completed a 6 point questionnaire, the same questionnaire was later administered by the attendant physician who was blinded to the scoring process. As no gold standard for defining relapse exists the attendant physician made a global assessment of relapse/ remission status using the available clinical, laboratory & endoscopic evidence.

Results: Scores were obtained for 74 presentations; age range 16–79 years, 51% male, 34% relapse rate. The mean patient score was 4.1 (range 0–14) & mean physician score 3.7 (0–14). There was excellent correlation between the scores obtained by the patient & physician (mean difference of 0.38, 95% CI 0.10–0.65). The self-administered SCCAI correlated well with a more complicated symptom & laboratory based activity index (Seo M et al. Am J Gastroenterol 1992;87:971–6) (r=0.77, p<0.01). The receiver-operator curve demonstrates the performance of the SCCAI scores in determining relapse. A score of 5 or more defines relapse with 92% sensitivity, 91% specificity, 85% positive predictive value & 89% negative predictive value.

Conclusions: The SCCAI is a simple tool that can be accurately self administered, correlates well with a more complicated disease activity index, & can be used to define relapse of UC with high specificity & sensitivity.