Original articleAlimentary tractValidation of the Ulcerative Colitis Colonoscopic Index of Severity and Its Correlation With Disease Activity Measures
Section snippets
Patients and Examination
Patients with UC and a spectrum of disease severity were prospectively recruited to this study, and written informed consent was obtained from all participants before inclusion. The study was approved by the Mayo Clinic Institutional Review Board. The patients included in the study had an established diagnosis of UC for ≥3 months and underwent colonoscopic assessment of their disease between December 2009 and June 2010. Those patients with prior colon surgery, indeterminate colitis, Crohn's
Patient Demographics and Video Clip Assessment
We recruited 53 patients to the study. Three patients were excluded because of poor bowel preparation or failed acquisition of digital video files. The remaining 50 patients had complete video recording of their colonoscopic assessment, and Table 2 shows their demographics and clinical information. The median age of the study patients was 46.5 years, and nearly half were men (48%). The most common indication for colonoscopy in our cohort was for assessment of activity of UC in 23 (46%),
Discussion
Mucosal healing has become an important measure of treatment efficacy in UC clinical trials, and hence there is an urgent need for a simple, reproducible, and validated scoring index of severity in UC. We found good IOA (reproducibility) among a group of experienced gastroenterologists for granularity, vascular pattern, bleeding/friability, and ulcerations. A composite score that used these 4 mucosal variables significantly accounted for the variations in the GAES. We validated the UCCIS score,
Acknowledgments
Presented in part at the Annual Meeting of the American Gastroenterological Association (DDW 2011), Chicago, Illinois, May 8–10, 2011.
References (25)
- et al.
Endoscopy in inflammatory bowel disease: indications, surveillance, and use in clinical practice
Clin Gastroenterol Hepatol
(2005) - et al.
Mucosal healing in inflammatory bowel disease: results from a Norwegian population-based cohort
Gastroenterology
(2007) - et al.
Early mucosal healing with infliximab is associated with improved long-term clinical outcomes in ulcerative colitis
Gastroenterology
(2011) We once were blind and now we see: is it time to treat ulcerative colitis to achieve mucosal healing?
Clin Gastroenterol Hepatol
(2011)- et al.
A review of activity indices and efficacy end points for clinical trials of medical therapy in adults with ulcerative colitis
Gastroenterology
(2007) - et al.
Automatic real-time detection of endoscopic procedures using temporal features
Comput Methods Programs Biomed
(2012) - et al.
Patchiness of mucosal inflammation in treated ulcerative colitis: a prospective study
Gastrointest Endosc
(1995) - et al.
Endoscopic and histological patchiness in treated ulcerative colitis
Am J Gastroenterol
(1999) - et al.
Physician assessment of ulcerative colitis activity correlates poorly with endoscopic disease activity
Inflamm Bowel Dis
(2011) - et al.
Infliximab for induction and maintenance therapy for ulcerative colitis
N Engl J Med
(2005)
Microscopic activity in ulcerative colitis: what does it mean?
Gut
Mucosal healing in inflammatory bowel disease: impossible ideal or therapeutic target?
Gut
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Conflicts of interest The authors disclose no conflicts.