title: Development of the Crohn's disease digestive damage score, the Lémann score.
abstract: Crohn's disease (CD) is a chronic progressive destructive disease. Currently available instruments measure disease activity at a specific point in time. An instrument to measure cumulative structural damage to the bowel, which may predict long-term disability, is needed. The aim of this article is to outline the methods to develop an instrument that can measure cumulative bowel damage. The project is being conducted by the International Program to develop New Indexes in Crohn's disease (IPNIC) group. This instrument, called the Crohn's Disease Digestive Damage Score (the Lémann score), should take into account damage location, severity, extent, progression, and reversibility, as measured by diagnostic imaging modalities and the history of surgical resection. It should not be "diagnostic modality driven": for each lesion and location, a modality appropriate for the anatomic site (for example: computed tomography or magnetic resonance imaging enterography, and colonoscopy) will be used. A total of 24 centers from 15 countries will be involved in a cross-sectional study, which will include up to 240 patients with stratification according to disease location and duration. At least 120 additional patients will be included in the study to validate the score. The Lémann score is expected to be able to portray a patient's disease course on a double-axis graph, with time as the x-axis, bowel damage severity as the y-axis, and the slope of the line connecting data points as a measure of disease progression. This instrument could be used to assess the effect of various medical therapies on the progression of bowel damage.
authors.affiliation: Department of Hepatogastroenterology, Hôpital Saint-Louis, Paris, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Pariente
authors.forename: Jacques
authors.initials: J
authors.lastname: Cosnes
authors.forename: Silvio
authors.initials: S
authors.lastname: Danese
authors.forename: William J
authors.initials: WJ
authors.lastname: Sandborn
authors.forename: Maïté
authors.initials: M
authors.lastname: Lewin
authors.forename: Joel G
authors.initials: JG
authors.lastname: Fletcher
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Chowers
authors.forename: Geert
authors.initials: G
authors.lastname: D'Haens
authors.forename: Brian G
authors.initials: BG
authors.lastname: Feagan
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Hommes
authors.forename: E Jan
authors.initials: EJ
authors.lastname: Irvine
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kamm
authors.forename: Edward V
authors.initials: EV
authors.lastname: Loftus
authors.forename: Edouard
authors.initials: E
authors.lastname: Louis
authors.forename: Pierre
authors.initials: P
authors.lastname: Michetti
authors.forename: Pia
authors.initials: P
authors.lastname: Munkholm
authors.forename: Tom
authors.initials: T
authors.lastname: Oresland
authors.forename: Julian
authors.initials: J
authors.lastname: Panés
authors.forename: Laurent
authors.initials: L
authors.lastname: Peyrin-Biroulet
authors.forename: Walter
authors.initials: W
authors.lastname: Reinisch
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Sands
authors.forename: Juergen
authors.initials: J
authors.lastname: Schoelmerich
authors.forename: Stefan
authors.initials: S
authors.lastname: Schreiber
authors.forename: Herbert
authors.initials: H
authors.lastname: Tilg
authors.forename: Simon
authors.initials: S
authors.lastname: Travis
authors.forename: Gert
authors.initials: G
authors.lastname: van Assche
authors.forename: Maurizio
authors.initials: M
authors.lastname: Vecchi
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Mary
authors.forename: Jean-Frédéric
authors.initials: JF
authors.lastname: Colombel
authors.forename: Marc
authors.initials: M
authors.lastname: Lémann
mesh_terms: D003106:Colon / Q000000981:diagnostic imaging / Q000473:pathology*; D003113:Colonoscopy; D003424:Crohn Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D018450:Disease Progression; D006801:Humans; D008279:Magnetic Resonance Imaging; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography