title: Development and validation of an endoscopic classification of diverticular disease of the colon: the DICA classification.
abstract: BACKGROUND
  A validated endoscopic classification of diverticular disease (DD) of the colon is lacking at present. Our aim was to develop a simple endoscopic score of DD: the Diverticular Inflammation and Complication Assessment (DICA) score.
  
  
  METHODS
  The DICA score for DD resulted in the sum of the scores for the extension of diverticulosis, the number of diverticula per region, the presence and type of inflammation, and the presence and type of complications: DICA 1 (≤ 3), DICA 2 (4-7) and DICA 3 (>7). A comparison with abdominal pain and inflammatory marker expression was also performed. A total of 50 videos of DD patients were reassessed in order to investigate the predictive role of DICA on the outcome of the disease.
  
  
  RESULTS
  Overall agreement in using DICA was 0.847 (95% confidence interval, CI, 0.812-0.893): 0.878 (95% CI 0.832-0.895) for DICA 1, 0.765 (95% CI 0.735-0.786) for DICA 2 and 0.891 (95% CI 0.845-0.7923) for DICA 3. Intra-observer agreement (kappa) was 0.91 (95% CI 0.886-0.947). A significant correlation was found between the DICA score and C-reactive protein values (p = 0.0001), as well as between the median pain score and the DICA score (p = 0.0001). With respect to the 50 patients retrospectively reassessed, occurrence/recurrence of disease complications was recorded in 29 patients (58%): 10 (34.5%) were classified as DICA 1 and 19 (65.5%) as DICA 2 (p = 0.036).
  
  
  CONCLUSIONS
  The DICA score is a simple, reproducible, validated and easy-to-use endoscopic scoring system for DD of the colon.
authors.affiliation: Gastroenterology Service, ASL BAT, Andria, Italy.
authors.forename: Antonio
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authors.lastname: Tursi
authors.forename: Giovanni
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authors.lastname: Brandimarte
authors.forename: Francesco
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authors.lastname: Di Mario
authors.forename: Arnaldo
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authors.lastname: Andreoli
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Annunziata
authors.forename: Marco
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authors.lastname: Astegiano
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Bianco
authors.forename: Luigi
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authors.lastname: Buri
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cammarota
authors.forename: Erminio
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authors.lastname: Capezzuto
authors.forename: Fausto
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authors.lastname: Chilovi
authors.forename: Massimo
authors.initials: M
authors.lastname: Cianci
authors.forename: Rita
authors.initials: R
authors.lastname: Conigliaro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Del Favero
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Cesare
authors.forename: Michela
authors.initials: M
authors.lastname: Di Fonzo
authors.forename: Walter
authors.initials: W
authors.lastname: Elisei
authors.forename: Roberto
authors.initials: R
authors.lastname: Faggiani
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Farroni
authors.forename: Giacomo
authors.initials: G
authors.lastname: Forti
authors.forename: Bastianello
authors.initials: B
authors.lastname: Germanà
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Giorgetti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Giovannone
authors.forename: Piera Giuseppina
authors.initials: PG
authors.lastname: Lecca
authors.forename: Silvano
authors.initials: S
authors.lastname: Loperfido
authors.forename: Riccardo
authors.initials: R
authors.lastname: Marmo
authors.forename: Piero
authors.initials: P
authors.lastname: Morucci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Occhigrossi
authors.forename: Antonio
authors.initials: A
authors.lastname: Penna
authors.forename: Alfredo Francesco
authors.initials: AF
authors.lastname: Rossi
authors.forename: Antonio
authors.initials: A
authors.lastname: Spadaccini
authors.forename: Costantino
authors.initials: C
authors.lastname: Zampaletta
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zilli
authors.forename: Angelo
authors.initials: A
authors.lastname: Zullo
authors.forename: Carmelo
authors.initials: C
authors.lastname: Scarpignato
authors.forename: Marcello
authors.initials: M
authors.lastname: Picchio
mesh_terms: D003106:Colon / Q000473:pathology*; D004240:Diverticulum / Q000145:classification* / Q000150:complications*; D004487:Edema / Q000150:complications / Q000473:pathology; D004724:Endoscopy; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000473:pathology*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results