1. Development and Validation of a Simple Ultrasound Activity Score for Crohn’s Disease
- Author
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Ragnar Eriksen, Kim Nylund, Odd Helge Gilja, Geir Egil Eide, and Fredrik Sævik
- Subjects
Crohn’s disease ,Adult ,Male ,medicine.medical_specialty ,Intraclass correlation ,Fistula ,Doppler echocardiography ,Severity of Illness Index ,Endoscopy, Gastrointestinal ,Crohn Disease ,medicine ,Humans ,Ultrasonography, Doppler, Color ,AcademicSubjects/MED00260 ,Monitoring, Physiologic ,Crohn's disease ,Receiver operating characteristic ,medicine.diagnostic_test ,ultrasound ,Norway ,business.industry ,activity index ,Ultrasound ,Patient Acuity ,Gastroenterology ,Reproducibility of Results ,Original Articles ,General Medicine ,Reference Standards ,medicine.disease ,Eccojc/1120 ,Intestines ,monitoring ,Stenosis ,Research Design ,Cohort ,Female ,Radiology ,business ,disease activity - Abstract
Background and Aims To improve management of patients with Crohn’s disease, objective measurements of disease activity are needed. Ileocolonoscopy is the current reference standard but has limitations that restrict repeated use. Ultrasonography is potentially useful for activity monitoring, but no validated sonographic activity index is currently in widespread use. Thus, we aimed to construct and validate a simple ultrasound score for Crohn’s disease. Methods Forty patients were prospectively examined with ultrasound and endoscopy in the development phase. The Simple Endoscopic Score for Crohn’s Disease [SES-CD] was used as a reference standard. Seven ultrasound variables [bowel wall thickness, length, colour Doppler, stenosis, fistula, stratification and fatty wrapping] were initially included, and multiple linear regression was used to select the variables that should be included in the final score. Second, the ultrasound data from each patient were re-examined for interobserver assessment using weighted kappa and intraclass correlation. Finally, the activity index was validated in a new cohort of 124 patients. Results Length, fistula and stenosis were excluded. The combination of the remaining variables provided a multiple correlation coefficient of r = 0.78. Interobserver analysis revealed poor agreement for stratification and fatty wrapping and these were thus excluded. There was excellent interobserver agreement for the remaining score consisting of wall thickness and colour Doppler. In both patient cohorts, the ultrasound score correlated well with SES-CD [Development cohort: rho = 0.83, p Conclusions A simple ultrasound activity index for Crohn’s disease consisting of bowel wall thickness and colour Doppler was constructed and validated and correlated well with endoscopic disease activity. ClinicalTrials. gov ID: NCT03481751
- Published
- 2020