BACKGROUND: The Pediatric Crohn's Disease Activity Index (PCDAI) has become the standard outcome measure in pediatric Crohn's disease (CD) clinical research. Other versions have been proposed but without systematic evaluation. The aim was to assess validity and responsiveness of the abbreviated PCDAI (abbrPCDAI), short PCDAI (shPCDAI), and modified PCDAI (modPCDAI) as measures of disease activity and to compare these with a mathematically weighted version developed here (wPCDAI). METHODS: The raw data from four prospectively collected datasets were used, totaling 437 children with CD (including two clinical trials). Discriminant validity utilized physician global assessment of disease activity (PGA), and construct validity the correlation with PGA and laboratory results. Feasibility and face validity were ascertained by a survey of 33 experts in pediatric CD. RESULTS: The wPCDAI had better performance than the PCDAI in construct validity and responsiveness and it discriminated better between the disease activity categories (area under the receiver operator characteristic [ROC] 0.97; 95% confidence interval [CI]: 0.95-0.99). In comparison to the original PCDAI, the noninvasive versions (abbrPCDAI and shPCDAI) had lower face, construct, and discriminant validity but were judged to be significantly more feasible. The modPCDAI performed well in the construct validation but was consistently inferior in all other parameters. Cutoffs that correspond to remission, response, and gradations of disease activity were determined for each index. CONCLUSIONS: The newly weighted wPCDAI performed better than the original PCDAI and is more feasible. The noninvasive versions (shPCDAI and abbrPCDAI) are inferior to the full PCDAI, but when needed in retrospective studies either may be equally used.
BACKGROUND: The Pediatric Crohn's Disease Activity Index (PCDAI) has become the standard outcome measure in pediatric Crohn's disease (CD) clinical research. Other versions have been proposed but without systematic evaluation. The aim was to assess validity and responsiveness of the abbreviated PCDAI (abbrPCDAI), short PCDAI (shPCDAI), and modified PCDAI (modPCDAI) as measures of disease activity and to compare these with a mathematically weighted version developed here (wPCDAI). METHODS: The raw data from four prospectively collected datasets were used, totaling 437 children with CD (including two clinical trials). Discriminant validity utilized physician global assessment of disease activity (PGA), and construct validity the correlation with PGA and laboratory results. Feasibility and face validity were ascertained by a survey of 33 experts in pediatric CD. RESULTS: The wPCDAI had better performance than the PCDAI in construct validity and responsiveness and it discriminated better between the disease activity categories (area under the receiver operator characteristic [ROC] 0.97; 95% confidence interval [CI]: 0.95-0.99). In comparison to the original PCDAI, the noninvasive versions (abbrPCDAI and shPCDAI) had lower face, construct, and discriminant validity but were judged to be significantly more feasible. The modPCDAI performed well in the construct validation but was consistently inferior in all other parameters. Cutoffs that correspond to remission, response, and gradations of disease activity were determined for each index. CONCLUSIONS: The newly weighted wPCDAI performed better than the original PCDAI and is more feasible. The noninvasive versions (shPCDAI and abbrPCDAI) are inferior to the full PCDAI, but when needed in retrospective studies either may be equally used.
Authors: J Dhaliwal; T D Walters; D R Mack; H Q Huynh; K Jacobson; A R Otley; J Debruyn; W El-Matary; C Deslandres; M E Sherlock; J N Critch; K Bax; E Seidman; P Jantchou; A Ricciuto; M Rashid; A M Muise; E Wine; M Carroll; S Lawrence; J Van Limbergen; E I Benchimol; P Church; A M Griffiths Journal: J Crohns Colitis Date: 2020-05-21 Impact factor: 9.071
Authors: Bonney Reed-Knight; Debra Lobato; Sarah Hagin; Elizabeth L McQuaid; Ronald Seifer; Sheryl J Kopel; Julie Boergers; Jack H Nassau; Kristina Suorsa; Barbara Bancroft; Neal S LeLeiko Journal: Child Health Care Date: 2013-10-22
Authors: Peter C Church; Mary-Louise C Greer; Ruth Cytter-Kuint; Andrea S Doria; Anne M Griffiths; Dan Turner; Thomas D Walters; Brian M Feldman Journal: Pediatr Radiol Date: 2017-03-10
Authors: Neal S LeLeiko; Debra Lobato; Sarah Hagin; Elizabeth McQuaid; Ronald Seifer; Sheryl J Kopel; Julie Boergers; Jack Nassau; Kristina Suorsa; Jason Shapiro; Barbara Bancroft Journal: Inflamm Bowel Dis Date: 2013 Mar-Apr Impact factor: 5.325
Authors: Bonney Reed-Knight; Debra Lobato; Sarah Hagin; Elizabeth L McQuaid; Ronald Seifer; Sheryl J Kopel; Julie Boergers; Jack H Nassau; Kristina Suorsa; Barbara Bancroft; Jason Shapiro; Neal S Leleiko Journal: Inflamm Bowel Dis Date: 2014-04 Impact factor: 5.325
Authors: Jennifer L Dotson; Wallace V Crandall; Peixin Zhang; Christopher B Forrest; L Charles Bailey; Richard B Colletti; Michael D Kappelman Journal: J Pediatr Gastroenterol Nutr Date: 2015-02 Impact factor: 2.839