Table 2

Operating properties of histological coeliac disease activity indices

Classification/grade/itemsContent validityConstruct validityReliabilityResponsivenessFeasibility
Histological
Marsh classification16Type 1: increased IEL count
Type 2: increased IEL count+crypt hyperplasia
Type 3: villus effacement and crypt hyperplasia
Type 4: total villous atrophy+crypt hypoplasia
??+
Modified Marsh-Oberhuber classification17Type 1: increased IEL count
Type 2: increased IEL count+crypt hyperplasia
Type 3: partial (a), subtotal (b) or total (c) villous atrophy
Type 4: destructive lesion
??+
Modified Marsh-Rostami classification18Type 1: increased IEL count
Type 2: increased IEL count+crypt hyperplasia
Type 3: partial (a), subtotal (b) or total (c) villous atrophy
000+
Corazza/Villanacci classification19Grade A: increased IEL count
Grade B1: increased IEL count+villous–crypt ratio <3:1
Grade B2: total villous atrophy
?+0+
Ensari classification20Type 1: increased IEL count
Type 2: increased IEL count+crypt hyperplasia+shortened villi
Type 3: total villous atrophy
?00+
Morphometry21Quantitative analysis of IEL count and villous height to crypt depth ratio+++?
  • +, positive; ?, indeterminate; −, negative; 0, no information available; IEL, intraepithelial lymphocytes.