Corey A Siegel1, Cynthia B Whitman2, Brennan M R Spiegel2, Brian Feagan3, Bruce Sands4, Edward V Loftus5, Remo Panaccione6, Geert D'Haens7, Charles N Bernstein8, Richard Gearry9, Siew C Ng10, Gerassimos J Mantzaris11, Balfour Sartor12, Mark S Silverberg13, Robert Riddell13, Ioannis E Koutroubakis14, Colm O'Morain15, Peter L Lakatos16, Dermot P B McGovern17, Jonas Halfvarson18, Walter Reinisch19, Gerhard Rogler20, Wolfgang Kruis21, Curt Tysk18, Stefan Schreiber22, Silvio Danese23, William Sandborn24, Anne Griffiths25, Bjorn Moum26, Christoph Gasche27, Francesco Pallone28, Simon Travis29, Julian Panes30, Jean-Frederic Colombel4, Stephen Hanauer31, Laurent Peyrin-Biroulet32. 1. Dartmouth-Hitchcock Inflammatory Bowel Disease Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. 2. Department of Health Services, Cedars-Sinai Medical Center, Los Angeles, California, USA. 3. Robarts Clinical Trials, London, Ontario, Canada. 4. Icahn School of Medicine at Mount Sinai, New York, New York, USA. 5. Mayo Clinic, Rochester, Minnesota, USA. 6. University of Calgary, Calgary, Alberta, Canada. 7. Academic Medical Center, Amsterdam, Netherlands. 8. University of Manitoba, Winnipeg, Manitoba, Canada. 9. University of Otago, Christchurch, New Zealand. 10. Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong. 11. Evangelismos-PolyCliniki-Ophthalmiatreion Hospital, Athens, Greece. 12. University of North Carolina, Chapel Hill, North Carolina, USA. 13. Mount Sinai Hospital, Toronto, Ontario, Canada. 14. University Hospital Heraklion, Crete, Greece. 15. Faculty of Health Sciences Trinity College Dublin, Dublin, Ireland. 16. Semmelweis University, Budapest, Hungary. 17. Widjaja Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA. 18. Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. 19. McMaster University, Hamilton, Ontario, Canada. 20. University Hospital of Zuürich, Zurich, Switzerland. 21. University of Cologne, Koln, Germany. 22. University Hopital Schleswig Holstein, Kiel, Germany. 23. Humanitas University, Milan, Italy. 24. UCSD, San Diego, California, USA. 25. Hospital for Sick Children, Toronto, Ontario, Canada. 26. Oslo University Hospital and University Oslo, Oslo, Norway. 27. Medical University and General Hospital Vienna, Vienna, Austria. 28. University of Rome Tor Vergata, Rome, Italy. 29. Oxford University Hospital, Oxford, UK. 30. Hospital Clinic de Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain. 31. Northwestern Feinberg School of Medicine, Chicago, Illinois, USA. 32. Inserm U954 and CHU de Nancy, Lorraine University, Nancy, France.
Abstract
BACKGROUND AND AIM: Disease activity for Crohn's disease (CD) and UC is typically defined based on symptoms at a moment in time, and ignores the long-term burden of disease. The aims of this study were to select the attributes determining overall disease severity, to rank the importance of and to score these individual attributes for both CD and UC. METHODS: Using a modified Delphi panel, 14 members of the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) selected the most important attributes related to IBD. Eighteen IOIBD members then completed a statistical exercise (conjoint analysis) to create a relative ranking of these attributes. Adjusted utilities were developed by creating proportions for each level within an attribute. RESULTS: For CD, 15.8% of overall disease severity was attributed to the presence of mucosal lesions, 10.9% to history of a fistula, 9.7% to history of abscess and 7.4% to history of intestinal resection. For UC, 18.1% of overall disease severity was attributed to mucosal lesions, followed by 14.0% for impact on daily activities, 11.2% C reactive protein and 10.1% for prior experience with biologics. Overall disease severity indices were created on a 100-point scale by applying each attribute's average importance to the adjusted utilities. CONCLUSIONS: Based on specialist opinion, overall CD severity was associated more with intestinal damage, in contrast to overall UC disease severity, which was more dependent on symptoms and impact on daily life. Once validated, disease severity indices may provide a useful tool for consistent assessment of overall disease severity in patients with IBD. 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/.
BACKGROUND AND AIM: Disease activity for Crohn's disease (CD) and UC is typically defined based on symptoms at a moment in time, and ignores the long-term burden of disease. The aims of this study were to select the attributes determining overall disease severity, to rank the importance of and to score these individual attributes for both CD and UC. METHODS: Using a modified Delphi panel, 14 members of the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) selected the most important attributes related to IBD. Eighteen IOIBD members then completed a statistical exercise (conjoint analysis) to create a relative ranking of these attributes. Adjusted utilities were developed by creating proportions for each level within an attribute. RESULTS: For CD, 15.8% of overall disease severity was attributed to the presence of mucosal lesions, 10.9% to history of a fistula, 9.7% to history of abscess and 7.4% to history of intestinal resection. For UC, 18.1% of overall disease severity was attributed to mucosal lesions, followed by 14.0% for impact on daily activities, 11.2% C reactive protein and 10.1% for prior experience with biologics. Overall disease severity indices were created on a 100-point scale by applying each attribute's average importance to the adjusted utilities. CONCLUSIONS: Based on specialist opinion, overall CD severity was associated more with intestinal damage, in contrast to overall UC disease severity, which was more dependent on symptoms and impact on daily life. Once validated, disease severity indices may provide a useful tool for consistent assessment of overall disease severity in patients with IBD. 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/.
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Authors: Maryam Alkhatry; Ahmad Al-Rifai; Vito Annese; Filippos Georgopoulos; Ahmad N Jazzar; Ahmed M Khassouan; Zaher Koutoubi; Rahul Nathwani; Mazen S Taha; Jimmy K Limdi Journal: World J Gastroenterol Date: 2020-11-21 Impact factor: 5.742
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