Aude Marchal-Bressenot1,2, Julia Salleron3, Camille Boulagnon-Rombi1, Claire Bastien4, Virginie Cahn5, Guillaume Cadiot6, Marie-Danièle Diebold1, Silvio Danese7, Walter Reinisch8, Stefan Schreiber9, Simon Travis10, Laurent Peyrin-Biroulet2,11. 1. Department of Pathology, University of Reims et Champagne-Ardenne, Reims, France. 2. Inserm U954, Genetic Nutrition and Exposure to Environmental Risks (NGERE), University of Lorraine, Vandoeuvre- lès-Nancy, France. 3. Department of Biostatistics, Institute de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France. 4. Department of Pathology, University Hospital of Lorraine, Vandoeuvre-lès-Nancy, France. 5. Department of Pathology, Centre Hospitalier Sud Francilien, Corbeil Essonnes, France. 6. Department of Hepato-Gastroenterology, University Hospital of Reims et Champagne-Ardenne, Reims, France. 7. Humanitas Clinical and Research Center and Humanitas University, Rozzano, Milan,Italy. 8. Department of Gastroenterology, IBD Center, Humanitas Research Hospital, Rozzano, Milan, Italy. 9. Department Medicine I, University-Hospital Schleswig-Holstein, Kiel, Germany. 10. Translational Gastroenterology Unit, Oxford University Hospitals, Oxford, UK. 11. Department of Hepato-Gastroenterology, University Hospital of Lorraine, Vandoeuvre-lès-Nancy, France.
Abstract
OBJECTIVE: We developed a validated index for assessing histological disease activity in UC and established its responsiveness. METHODS: Two hundred biopsies were scored. The outcome was the Global Visual Evaluation (GVE). Eight histological features were tested. The Nancy index was developed by multiple linear regression and bootstrap process to create an index that best matched the GVE. Goodness of fit was assessed by the adjusted R squared (adjusted R2). The second step was the validation of the index: 100 biopsies were scored for the Nancy index by three pathologists from different centres. Inter-reader reliability was evaluated for each reader. The relationship between the change of the Nancy index and the Geboes index was assessed to assess the responsiveness. RESULTS: After backward selection with bootstrap validation, 3/8 items were selected: ulceration (adjusted R2=0.55), acute inflammatory infiltrate (adjusted R2=0.88) and chronic inflammatory infiltrate (adjusted R2=0.79). The Nancy index is defined by a 5-level classification ranging from grade 0 (absence of significant histological disease activity) to grade 4 (severely active disease). The intraclass correlation coefficient (ICC) for the intrareader reliability was 0.88 (95% CI 0.82 to 0.92) and the index had good inter-reader reliability (ICC=0.86 (0.81 to 0.99)). The correlation between the Nancy index and the Geboes score or the GVE was very good. The index had a good responsiveness with a high correlation between changes in the Geboes score and changes in the Nancy index (0.910 (0.813 to 0.955)). CONCLUSIONS: A three descriptor histological index has been validated for use in clinical practice and clinical trials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
OBJECTIVE: We developed a validated index for assessing histological disease activity in UC and established its responsiveness. METHODS: Two hundred biopsies were scored. The outcome was the Global Visual Evaluation (GVE). Eight histological features were tested. The Nancy index was developed by multiple linear regression and bootstrap process to create an index that best matched the GVE. Goodness of fit was assessed by the adjusted R squared (adjusted R2). The second step was the validation of the index: 100 biopsies were scored for the Nancy index by three pathologists from different centres. Inter-reader reliability was evaluated for each reader. The relationship between the change of the Nancy index and the Geboes index was assessed to assess the responsiveness. RESULTS: After backward selection with bootstrap validation, 3/8 items were selected: ulceration (adjusted R2=0.55), acute inflammatory infiltrate (adjusted R2=0.88) and chronic inflammatory infiltrate (adjusted R2=0.79). The Nancy index is defined by a 5-level classification ranging from grade 0 (absence of significant histological disease activity) to grade 4 (severely active disease). The intraclass correlation coefficient (ICC) for the intrareader reliability was 0.88 (95% CI 0.82 to 0.92) and the index had good inter-reader reliability (ICC=0.86 (0.81 to 0.99)). The correlation between the Nancy index and the Geboes score or the GVE was very good. The index had a good responsiveness with a high correlation between changes in the Geboes score and changes in the Nancy index (0.910 (0.813 to 0.955)). CONCLUSIONS: A three descriptor histological index has been validated for use in clinical practice and clinical trials. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Kelly C Cushing; William Tan; David H Alpers; Vikram Deshpande; Ashwin N Ananthakrishnan Journal: Aliment Pharmacol Ther Date: 2019-11-07 Impact factor: 8.171
Authors: Robert Battat; Niels Vande Casteele; Rish K Pai; Zhongya Wang; Guangyong Zou; John W D McDonald; Marjolijn Duijvestein; Jenny Jeyarajah; Claire E Parker; Tanja Van Viegen; Sigrid A Nelson; Brigid S Boland; Siddharth Singh; Parambir S Dulai; Mark A Valasek; Brian G Feagan; Vipul Jairath; William J Sandborn Journal: Aliment Pharmacol Ther Date: 2020-09-27 Impact factor: 8.171
Authors: Robert Battat; Parambir S Dulai; Christopher Ma; Vipul Jairath; Brian G Feagan; William J Sandborn; Reena Khanna Journal: Curr Treat Options Gastroenterol Date: 2020-01-04
Authors: Yan Li; Benedikt Schaarschmidt; Lale Umutlu; Michael Forsting; Aydin Demircioglu; Anna Katharina Koch; Ole Martin; Ken Herrmann; Hendrik Juette; Andrea Tannapfel; Jost Langhorst Journal: Eur J Nucl Med Mol Imaging Date: 2019-10-24 Impact factor: 9.236
Authors: Manisha Bajpai; Darren N Seril; James Van Gurp; Xin Geng; Janet Alvarez; Carlos D Minacapelli; Steve Gorin; Koushik K Das; Elizabeth Poplin; Jerry Cheng; Peter S Amenta; Kiron M Das Journal: Dig Dis Sci Date: 2018-11-26 Impact factor: 3.199
Authors: Klaus Fellermann; Ingolf Schiefke; István Rácz; Jelena Derova; Laimas Jonaitis; Sarah Wehrum; Tanju Nacak; Roland Greinwald Journal: United European Gastroenterol J Date: 2020-10-07 Impact factor: 4.623