Yunho Jung1, Young Hwangbo2, Soon Man Yoon3, Hoon Sup Koo4, Hyun Deok Shin5, Jeong Eun Shin5, Hee Seok Moon6, Sang Bum Kang7, Jeong Rok Lee8, Kyu Chan Huh4. 1. Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan-si, Chungcheongnam-do, South Korea. 2. Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan-si, Chungcheongnam-do, South Korea. 3. Department of Internal Medicine, Chungbuk National University Hospital, Cheongju-si, Chungcheongbuk-do, South Korea. 4. Department of Internal Medicine, Konyang University of Medicine, Daejeon, South Korea. 5. Department of Internal Medicine, Dankook University College of Medicine, Cheonan-si, Chungcheongnam-do, South Korea. 6. Department of Internal Medicine, Chungnam National University Hospital, Daejeon, South Korea. 7. Department of Internal Medicine, Daejeon St Mary's Hospital, College of Medicine, Daejeon, South Korea. 8. Department of Internal Medicine, Konkuk University School of Medicine, Chungju-si, Chungcheongbuk-do, South Korea.
Abstract
OBJECTIVES: A differential diagnosis between intestinal tuberculosis (ITB) and Crohn's disease (CD) is challenging. The aim of this study was to investigate the clinical, endoscopic, and histological features and to create a predictive score model for differentiating CD and ITB. METHODS: In total, 261 patients, 99 with ITB and 162 with CD, were recruited from seven tertiary centers from 2005 to 2013 and reviewed retrospectively. For the creation of a validated model, parameters were selected by univariate logistic regression and receiver operating characteristic curve analyses. Then, the prediction model was established on the basis of β-coefficients of the multivariate logistic regression. For the validation of the model, the same regression equation was tested on the other group. RESULTS: Age, diarrhea, ring-shaped ulcer, longitudinal ulcer, sigmoid involvement, suspicious radiological pulmonary tuberculosis, and gender were selected as the factors for a seven-marker model. In the seven-marker model of the validation data set, the sensitivity, specificity, positive predictive value, and negative predictive value with a cutoff level of 0.35 were 98.0, 92.4, 88.9, and 98.6, respectively. CONCLUSIONS: The seven-marker model seems to be highly reliable for differentiating between ITB and CD and could be conveniently used by clinicians to obtain results.
OBJECTIVES: A differential diagnosis between intestinal tuberculosis (ITB) and Crohn's disease (CD) is challenging. The aim of this study was to investigate the clinical, endoscopic, and histological features and to create a predictive score model for differentiating CD and ITB. METHODS: In total, 261 patients, 99 with ITB and 162 with CD, were recruited from seven tertiary centers from 2005 to 2013 and reviewed retrospectively. For the creation of a validated model, parameters were selected by univariate logistic regression and receiver operating characteristic curve analyses. Then, the prediction model was established on the basis of β-coefficients of the multivariate logistic regression. For the validation of the model, the same regression equation was tested on the other group. RESULTS: Age, diarrhea, ring-shaped ulcer, longitudinal ulcer, sigmoid involvement, suspicious radiological pulmonary tuberculosis, and gender were selected as the factors for a seven-marker model. In the seven-marker model of the validation data set, the sensitivity, specificity, positive predictive value, and negative predictive value with a cutoff level of 0.35 were 98.0, 92.4, 88.9, and 98.6, respectively. CONCLUSIONS: The seven-marker model seems to be highly reliable for differentiating between ITB and CD and could be conveniently used by clinicians to obtain results.
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Authors: Julajak Limsrivilai; Andrew B Shreiner; Ananya Pongpaibul; Charlie Laohapand; Rewat Boonanuwat; Nonthalee Pausawasdi; Supot Pongprasobchai; Sathaporn Manatsathit; Peter D R Higgins Journal: Am J Gastroenterol Date: 2017-01-03 Impact factor: 10.864