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Development and Validation of a Simple Ultrasound Activity Score for Crohn's Disease.


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?ConclusionsA 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.

SUBMITTER: Sævik F 

PROVIDER: S-EPMC7805799 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Development and Validation of a Simple Ultrasound Activity Score for Crohn's Disease.

Sævik Fredrik F   Eriksen Ragnar R   Eide Geir Egil GE   Gilja Odd Helge OH   Nylund Kim K  

Journal of Crohn's & colitis 20210101 1


<h4>Background and aims</h4>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.<h4>Methods</h4>Forty patients were p  ...[more]

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