title: Measurement of Inflammatory Bowel Disease Symptoms: Reliability of an Abbreviated Approach to Data Collection.
abstract: BACKGROUND
  The Crohn's Disease Activity Index (CDAI) and Mayo score for ulcerative colitis (UC) require symptom recall and/or use of a symptom diary. We examined patients' abilities to recall their symptoms and the day-to-day variability of symptoms.
  
  
  METHODS
  Patients with UC or CD completed a questionnaire including items from the short CDAI (sCDAI) and the 6-point Mayo score. Patients were randomized to receive a follow-up questionnaire testing recall of the bowel symptom items between 1 and 7 days later. In a second study, patients completed a 7-day electronic diary recording their symptoms. sCDAI and 6-point Mayo scores were computed. Analyses estimated daily variability in the indices and misclassification rates when using fewer than 7 days of data.
  
  
  RESULTS
  100%, 82%, and 90% of CD participants recalled the same disease activity status (i.e., active versus remission) as reported on the initial survey when the follow-up questionnaire was administered 1 to 2, 3 to 5, and 6 to 8 days later, respectively. Compared with using 7 days of data, when using only day 7 data, 3.7% of patients with CD were misclassified as active or inactive. Disease activity was misclassified in 2.8%, 4.9%, and 3.3% of patients by using the last 2, 3, or 4 days, respectively. Results were similar for patients with UC.
  
  
  CONCLUSIONS
  Patients with CD and UC demonstrated good recall of bowel symptoms for up to 8 days. Additionally, bowel symptoms have relatively little variability within a 7-day period allowing for accurate computation of the sCDAI and 6-point Mayo score using 1 to 3 days of data.
authors.affiliation: Departments of *Medicine, and †Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; ‡Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and §Departments of Medicine and Public Health Sciences, Pennsylvania State College of Medicine, Hershey, Pennsylvania.
authors.forename: Maria Paula
authors.initials: MP
authors.lastname: Henao
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Bewtra
authors.forename: Mark T
authors.initials: MT
authors.lastname: Osterman
authors.forename: Faten N
authors.initials: FN
authors.lastname: Aberra
authors.forename: Frank I
authors.initials: FI
authors.lastname: Scott
authors.forename: Gary R
authors.initials: GR
authors.lastname: Lichtenstein
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kraschnewski
authors.forename: James D
authors.initials: JD
authors.lastname: Lewis
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000523:psychology; D003424:Crohn Disease / Q000175:diagnosis* / Q000523:psychology; D000068598:Data Accuracy; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*; D063189:Symptom Assessment / Q000523:psychology*