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Standard severity index validated for endoscopic assessment of ulcerative colitis
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Researchers used a library of 670 video sigmoidoscopies to devise and calibrate an endoscopic index of severity for ulcerative colitis.
The study’s first phase mapped inconsistencies in endoscopic assessment and defined the most reliable descriptive terms. Phase 2 quantified the inter- and intraobserver variation among the descriptors, from which a new Ulcerative Colitis Endoscopy Index of Severity was validated.
Variability in endoscopic assessment motivated the researchers to devise and validate more concise descriptors.
The 10 descriptors in the final model include vascular pattern (normal, patchy, complete obliteration); bleeding (none, mucosal, luminal mild, luminal moderate, severe); and erosions and ulcers (none, erosions, superficial, deep), each with precise definitions. These explained 90% of the variance in the assessment of endoscopic severity.
“The ‘gold standard’ for assessing disease activity in [ulcerative colitis] should be a diagnostic test than can accurately predict future disease outcome, to augment clinical evaluation,” the study authors wrote. “The burden of proof has to be on endoscopy, as an expensive and invasive test, to prove that it is better than non-invasive and less expensive alternatives.
Disclosure: The researchers report no relevant financial disclosures.