A new Simple Endoscopic Score for Ulcerative Colitis - the SES-UC

Area of Science:

• Gastroenterology
• Endoscopic assessment
• Inflammatory bowel disease

Background:

• Endoscopy is the gold standard for evaluating ulcerative colitis (UC) disease activity.
• Current endoscopic indices, like the Mayo Endoscopic Subscore (MES), have limitations.
• Existing indices lack widespread adoption due to feasibility issues.

Purpose of the Study:

• To develop a simple, reliable endoscopic index for UC.
• To compare the MES, Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and Ulcerative Colitis Colonoscopic Index of Severity (UCCIS).
• To examine agreement between colonoscopy and sigmoidoscopy for UC assessment.

Main Methods:

• Video recordings of colonoscopies from UC patients were segmented.
• Gastroenterologists scored video segments using disease activity descriptors.
• Collected data included clinical, fecal, and mucosal samples.

Main Results:

• The Simple Endoscopic Score for Ulcerative Colitis (SES-UC) was developed from vascular pattern and ulcer descriptors.
• SES-UC demonstrated reliability and accuracy comparable to MES, UCEIS, and UCCIS.
• Sigmoidoscopy missed proximal UC disease in up to 38% of patients.

Conclusions:

• The SES-UC is a simple, reliable endoscopic index for UC.
• SES-UC performance is similar to, and in some aspects better than, existing indices.
• SES-UC is suitable for clinical practice and research in UC.