Disease activity for Crohn's disease and ulcerative colitis is typically defined based on symptoms at a moment in time, and ignores the long-term burden of disease.
Dr Corey Siegel and colleagues from New Hampshire, USA selected the attributes determining overall disease severity, to rank the importance of and to score these individual attributes for both Crohn's disease and ulcerative colitis.
Using a modified Delphi panel, 14 members of the International Organization for the Study of Inflammatory Bowel Diseases selected the most important attributes related to inflammatory bowel disease.
Eighteen International Organization for the Study of Inflammatory Bowel Diseases members then completed a statistical exercise to create a relative ranking of these attributes.
The team developed adjusted by creating proportions for each level within an attribute.
|For Crohn's disease, 16% of overall disease severity was attributed to the presence of mucosal lesions|
For Crohn's disease, 16% of overall disease severity was attributed to the presence of mucosal lesions, 11% to history of a fistula, 10% to history of abscess, and 7% to history of intestinal resection.
For ulcerative colitis, the team found that 18% of overall disease severity was attributed to mucosal lesions, followed by 14% for impact on daily activities, 11% C reactive protein, and 10% for prior experience with biologics.
The team created overall disease severity indices on a 100-point scale by applying each attribute's average importance to the adjusted utilities.
Dr Siegel's team concludes, " Based on specialist opinion, overall Crohn's disease severity was associated more with intestinal damage, in contrast to overall ulcerative colitis 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 inflammatory bowel disease."