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Defining relapse of ulcerative colitis using a symptom-based activity index.
S L Jowett1, C J Seal, E Phillips
1University of Newcastle Faculty of Medicine, North Tyneside Hospital, North Shields, Tyne and Wear, UK.
Scandinavian Journal of Gastroenterology
|April 8, 2003
Summary
A Simple Clinical Colitis Activity Index (SCCAI) score of 5 or more effectively defines ulcerative colitis (UC) relapse. This validated tool is reliable for self-administration, aiding in accurate disease activity assessment.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Inflammatory Bowel Disease Research
Background:
- Ulcerative colitis (UC) disease activity assessment tools exist, but a standardized definition for relapse is lacking.
- The Simple Clinical Colitis Activity Index (SCCAI) is a potential tool for UC management.
- Reliability and validity of self-administered SCCAI require evaluation.
Purpose of the Study:
- Determine the SCCAI score threshold indicative of UC relapse.
- Assess the reliability and validity of the self-administered SCCAI.
- Establish a clear definition for UC relapse using SCCAI.
Main Methods:
- Patients with UC completed the SCCAI questionnaire.
- Clinicians administered the SCCAI blinded to patient scores.
- A subjective global assessment by clinicians served as a reference for relapse.
- SCCAI was validated in a separate patient cohort.
Main Results:
- A SCCAI score of 5 or higher demonstrated high sensitivity (92%) and specificity (93%) for defining UC relapse.
- Patient and clinician SCCAI scores showed minimal difference, indicating good agreement.
- SCCAI strongly correlated with a complex disease activity index (r = 0.79, P < 0.01).
Conclusions:
- The SCCAI is a simple, reliable, and valid tool for self-administration in UC patients.
- SCCAI can accurately define UC relapse with high sensitivity and specificity.
- This index facilitates quick and accurate assessment of UC disease activity.