title: Diagnostic Performance of the Simple Clinical Colitis Activity Index Self-Administered Online at Home by Patients With Ulcerative Colitis: CRONICA-UC Study.
abstract: OBJECTIVE
  New e-health technologies can improve patient-physician communication and contribute to optimal patient care. We compared the diagnostic performance of the Simple Clinical Colitis Activity Index (SCCAI) self-administered by patients with ulcerative colitis (UC) at home (through a website) with the in-clinic gastroenterologist-assessed SCCAI.
  
  
  METHODS
  Patients were followed-up over 6 months. At months 3 and 6, patients completed the SCCAI online at home; within 48 h, gastroenterologists (blinded to patients' scores) completed the in-clinic SCCAI (reference). SCCAI scores were dichotomized to remission or active disease, and SCCAI changes in disease activity from month 3 to 6 were classed as worsening, stability, or improvement.
  
  
  RESULTS
  A total of 199 patients (median age: 38 years; 56% female) contributed with 340 pairs of questionnaires. Correlation of SCCAI scores by patients and physicians was good (Spearman's ρ=0.79), with 85% agreement for remission or activity (95% CI: 80.8-88.6, κ=0.66). The negative predictive value for active disease was 94.5% (91.4-96.6); the positive predictive value was 68.0% (58.8-69.2). Agreement between patient and physician was higher in the 168 month 6 pairs than in the 172 month 3 pairs of questionnaires (89.3% (83.6-93.1) vs. 80.8% (74.2-86.0), P=0.027).
  
  
  CONCLUSIONS
  In patients with UC, SCCAI self-administration via an online tool resulted in a high percentage of agreement with evaluation by gastroenterologists, with a remarkably high negative predictive value for disease activity. Remote monitoring of UC patients is possible and might reduce hospital visits.
authors.affiliation: Gastroenterology Unit, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Marín-Jiménez
authors.affiliation: Department of Gastroenterology, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Nos
authors.affiliation: Gastroenterology Unit, Hospital Universitari Germans Trias i Pujol (Badalona), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Badalona, Spain.
authors.forename: Eugeni
authors.initials: E
authors.lastname: Domènech
authors.affiliation: Department of Gastroenterology, Inflammatory Bowel Disease Unit, Central University Hospital of Asturias, Oviedo, Spain.
authors.forename: Sabino
authors.initials: S
authors.lastname: Riestra
authors.affiliation: Gastroenterology Unit, Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria Princesa (IIS-IP), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y digestivas (CIBERehd), Madrid, Spain.
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
authors.affiliation: Gastroenterology Unit, Hospital de Sabadell e Institut Universitari Parc Tauli, Sabadell, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Calvet
authors.affiliation: Gastroenterology Unit, Hospital de Sagunto, Valencia, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Cortés
authors.affiliation: Department of Gastroenterology, Hospital Universitario Reina Sofia, Córdoba, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Iglesias
authors.affiliation: Hospital General Universitario de Valencia, Valencia, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Huguet
authors.affiliation: Gastroenterology Unit, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Taxonera
authors.affiliation: Gastroenterology Unit, Hospital General de Jaén, Jaén, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Fernández
authors.affiliation: IBD Unit, Complexo Hospitalario de Pontevedra, Pontevedra, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Carpio
authors.affiliation: Gastroenterology Unit, Hospital General Universitario Alicante, Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd), Alicante, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Gutiérrez
authors.affiliation: Gastroenterology Unit Hospital de Bellvitge, Idibell, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Guardiola
authors.affiliation: Gastroenterology Unit, Hospital Universitario Virgen Macarena, Sevilla, Spain.
authors.forename: Luisa Castro
authors.initials: LC
authors.lastname: Laria
authors.affiliation: Gastroenterology Unit, Hospital General de Burgos, Burgos, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Sicilia
authors.affiliation: Department of Gastroenterology, Hospital Donostia/Instituto Biodonostia, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universidad del País Vasco (UPV/EHU), San Sebastián, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Bujanda
authors.affiliation: Medical Affairs Department, Merck Sharp & Dohme Spain, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Cea-Calvo
authors.affiliation: Medical Affairs Department, Merck Sharp & Dohme Spain, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Romero
authors.affiliation: Medical Affairs Department, Merck Sharp & Dohme Spain, Madrid, Spain.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Rincón
authors.affiliation: Medical Affairs Department, Merck Sharp & Dohme Spain, Madrid, Spain.
authors.forename: Berta
authors.initials: B
authors.lastname: Juliá
authors.affiliation: Department of Gastroenterology, Hospital Clínic de Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain.
authors.forename: Julián
authors.initials: J
authors.lastname: Panés
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000503:physiopathology; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D017216:Telemedicine; D055815:Young Adult