RT Journal Article
SR Electronic
T1 Development of an index to define overall disease severity in IBD
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 244
OP 254
DO 10.1136/gutjnl-2016-312648
VO 67
IS 2
A1 Siegel, Corey A
A1 Whitman, Cynthia B
A1 Spiegel, Brennan M R
A1 Feagan, Brian
A1 Sands, Bruce
A1 Loftus, Edward V
A1 Panaccione, Remo
A1 D'Haens, Geert
A1 Bernstein, Charles N
A1 Gearry, Richard
A1 Ng, Siew C
A1 Mantzaris, Gerassimos J
A1 Sartor, Balfour
A1 Silverberg, Mark S
A1 Riddell, Robert
A1 Koutroubakis, Ioannis E
A1 O'Morain, Colm
A1 Lakatos, Peter L
A1 McGovern, Dermot P B
A1 Halfvarson, Jonas
A1 Reinisch, Walter
A1 Rogler, Gerhard
A1 Kruis, Wolfgang
A1 Tysk, Curt
A1 Schreiber, Stefan
A1 Danese, Silvio
A1 Sandborn, William
A1 Griffiths, Anne
A1 Moum, Bjorn
A1 Gasche, Christoph
A1 Pallone, Francesco
A1 Travis, Simon
A1 Panes, Julian
A1 Colombel, Jean-Frederic
A1 Hanauer, Stephen
A1 Peyrin-Biroulet, Laurent
YR 2018
UL http://gut.bmj.com/content/67/2/244.abstract
AB Background and aim Disease activity for Crohn's disease (CD) and UC is typically defined based on symptoms at a moment in time, and ignores the long-term burden of disease. The aims of this study were to select the attributes determining overall disease severity, to rank the importance of and to score these individual attributes for both CD and UC.Methods Using a modified Delphi panel, 14 members of the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) selected the most important attributes related to IBD. Eighteen IOIBD members then completed a statistical exercise (conjoint analysis) to create a relative ranking of these attributes. Adjusted utilities were developed by creating proportions for each level within an attribute.Results For CD, 15.8% of overall disease severity was attributed to the presence of mucosal lesions, 10.9% to history of a fistula, 9.7% to history of abscess and 7.4% to history of intestinal resection. For UC, 18.1% of overall disease severity was attributed to mucosal lesions, followed by 14.0% for impact on daily activities, 11.2% C reactive protein and 10.1% for prior experience with biologics. Overall disease severity indices were created on a 100-point scale by applying each attribute's average importance to the adjusted utilities.Conclusions Based on specialist opinion, overall CD severity was associated more with intestinal damage, in contrast to overall UC disease severity, which was more dependent on symptoms and impact on daily life. Once validated, disease severity indices may provide a useful tool for consistent assessment of overall disease severity in patients with IBD.