Defining relapse of ulcerative colitis using a symptom-based activity index
Defining relapse of ulcerative colitis using a symptom-based activity index
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DOI：
10.1080/00365520310000654
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发表时间：
2003-02-01
影响因子：
1.9
通讯作者：
Welfare, MR
中科院分区：
文献类型：
--
作者：
Jowett, SL;Seal, CJ;Welfare, MR
背景：有几种工具可以评估溃疡性结肠炎（UC）患者的疾病活动性，但复发的定义并不存在。该研究的目的是确定简单临床结肠炎活动指数（SCCAI）中定义复发的评分。自我管理时SCCAI的信度和效度也进行了检查。研究方法：UC患者定期住院完成SCCAI问卷，随后由对其评分过程不知情的临床医生进行管理。在缺乏复发的金标准定义的情况下，由临床医生对疾病状态进行主观的总体评估。在单独的患者队列中评价SCCAI。结果：分析了71例病例，平均年龄48岁，49%为男性，37%复发率。平均患者评分为4.2（范围0-14），平均医生评分为3.8（0-14）。5分或5分以上定义复发，敏感性为92%，特异性为93%，阳性预测值为88%，阴性预测值为95%。患者和临床医生获得的评分之间的差异（0.35，95% CI 0.09-0.62）较小。复杂症状与实验室活动指数的相关性非常高（r = 0.79，P < 0.01）。该指数使用迅速，并在第二组患者中记录了敏感性和特异性的比较结果。结论：SCCAI是一种简单的工具，可以准确快速地自我管理，与更复杂的疾病活动指数相关性良好，并可用于定义UC复发，具有高特异性和灵敏度。
Background: Several tools exist to assess disease activity in patients with ulcerative colitis (UC), but a definition of relapse does not exist. The aim of the study was to determine the score in the Simple Clinical Colitis Activity Index (SCCAI) that defined relapse. The reliability and validity of the SCCAI when self-administered was also examined. Methods: Patients with UC routinely attending hospital completed the SCCAI questionnaire, which was later administered by their clinician blinded to the scoring process. In the absence of a gold standard definition of relapse, a subjective global assessment of disease status was made by the clinician. The SCCAI was evaluated in a separate cohort of patients. Results: Seventy-one presentations were analysed; mean age 48 years, 49% male, 37% relapse rate. The mean patient score was 4.2 (range 0-14) and mean physician score 3.8 (0-14). A score of 5 or more defined relapse with 92% sensitivity, 93% specificity, 88% positive predictive value and 95% negative predictive value. The difference between the scores obtained by the patient and clinician (0.35, 95% Cl 0.09-0.62) was small. Correlation with a more complex symptom and laboratory-based activity index was very high (r = 0.79, P < 0.01). The index was quick to use and comparative results for sensitivity and specificity were recorded in the second cohort of patients. Conclusions: The SCCAI is a simple tool that can be accurately and quickly self-administered, correlates well with a more complex disease activity index, and can be used to define relapse of UC with high specificity and sensitivity.