Citations 2
Development of an index to define overall disease severity in IBD
Whitman, Cynthia B. , Spiegel, Brennan , Feagan, Brian G. , Loftus, Edward V. , D’Haens, Geert , Bernstein, Çharles N. , Gearry, Richard B. , Mantzaris, Gerassimos J. , Sartor, Balfour R., Silverberg, Mark S. , Riddell, Robert H. , O’Morain, Colm, Lakatos, Péter L. , Halfvarson, Jonas , Reinisch, Walter, Rogler, Gerhard , Kruis, Wolfgang , Tysk, Curt , Danese, Silvio , Sandborn, William J. , Gasché, Christoph , Pallone, Francesco, Travis, Simon , Peyrin‐Biroulet, Laurent , Siegel, Corey A , Sands, Bruce E , Panaccione, Remo , Bernstein, Charles Noah , Ng, Siew C. , Κoutroubakis, Ioannis E. , McGovern, Dermot , Halfvarson, Jonas , Schreiber, Stefan , Griffiths, Anne Marie , Moum, Bjørn Allan , Panés, Julián , Colombel, Jean‐Frédéric , Hanauer, Stephen B. , Loftus, Edward V , Danese, Silvio , Peyrin-Biroulet, Laurent , Spiegel, Brennan , Lakatos, Peter L
Gut | October 25, 2016 | Volume: 67 | Issue: 2 | Pages: 244-254
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.
Toward an Integrated Clinical, Molecular and Serological Classification of Inflammatory Bowel Disease: Report of a Working Party of the 2005 Montreal World Congress of Gastroenterology
Silverberg, Mark S. , Satsangi, Jack, Ahmad, Tariq , Arnott, Ian , Bernstein, Çharles N. , Caprilli, R., Colombel, Jean–Frédéric, Gasché, Christoph , Geboes, Karel, Jewell, Derek P., Karban, Amir, Peña, A. S. , Riddell, Robert H. , Sachar, David B., Steinhart, A. Hillary , Targan, Stephan R. , Vermeire, Séverine , Warren, Bryan F., Bernstein, Charles Noah , Brant, Steven R , Loftus, Edward V. , Schreiber, Stefan , Vermeire, Séverine
Canadian Journal of Gastroenterology | May 17, 2016 | Volume: 19 | Issue: suppl a | Pages: 5A-36A
The discovery of a series of genetic and serological markers associated with disease susceptibility and phenotype in inflammatory bowel disease has led to the prospect of an integrated classification system involving clinical, serological and genetic parameters. The Working Party has reviewed current clinical classification systems in Crohn’s disease, ulcerative colitis and indeterminate colitis, and provided recommendations for clinical classification in practice. Progress with respect to integrating serological and genetic markers has been examined in detail, and the implications are discussed. While an integrated system is not proposed for clinical use at present, the introduction of a widely acceptable clinical subclassification is strongly advocated, which would allow detailed correlations among serotype, genotype and clinical phenotype to be examined and confirmed in independent cohorts of patients and, thereby, provide a vital foundation for future work.