title: Validation of a Simple 0 to 10 Numerical Score (IBD-10) of Patient-reported Inflammatory Bowel Disease Activity for Routine Clinical Use.
abstract: Various physician- and patient-reported instruments exist for quantification of disease activity in inflammatory bowel diseases (IBD) but none are widely used in routine clinical practice. A simple patient-reported outcome measure might help inform clinical decision making. We evaluated a patient-reported 0 to 10 score of IBD activity (IBD-10) by correlation with conventional multicomponent activity indices.
  
  
  
  A single-center prospective cross-sectional study was conducted in ambulant patients with IBD. Patients were asked to verbally rate the control of Crohn's disease (CD) or ulcerative colitis (UC) on a numerical scale from 0 to 10, with 10 indicating perfect control. Disease activity was assessed using Harvey-Bradshaw index for CD and simple clinical colitis activity index for UC.
  
  
  
  A total of 405 patients were included, of whom 209 (52%) had CD and 196 (48%) had UC. The median age was 41 (interquartile range, 27-55) years. IBD-10 correlated well with Harvey-Bradshaw Index (rs = -0.69, P < 0.001) and simple clinical colitis activity index (rs = -0.79, P < 0.001). An IBD-10 score of ≥7 predicted remission (defined by Harvey-Bradshaw index/simple clinical colitis activity index) with 90% sensitivity (95% confidence interval [CI], 86-94) and 75% specificity (95% CI, 67-82). The discriminatory ability of IBD-10 for remission was better for UC (area under the receiver operating characteristic curve, 0.93; 95% CI, 0.89-0.97) than for CD (area under the receiver operating characteristic curve, 0.86; 95% CI, 0.81-0.91; P = 0.035). An IBD-10 score of <7 correlated with treatment escalation.
  
  
  
  The IBD-10 score correlates well with more complex clinical activity indices. Correlation was less strong for CD than for UC, possibly reflecting a weaker link in CD between stool frequency and the patient perspective of disease activity. The IBD-10 score could readily be used in routine clinical practice.
authors.affiliation: *Department of Gastroenterology, Royal Liverpool University Hospital, Liverpool, United Kingdom;†Cancer Research UK, Liverpool Cancer Trials Unit, Liverpool, United Kingdom; and‡Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Sreedhar
authors.initials: S
authors.lastname: Subramanian
authors.forename: Rebecca
authors.initials: R
authors.lastname: Asher
authors.forename: William
authors.initials: W
authors.lastname: Weston
authors.forename: Michael
authors.initials: M
authors.lastname: Rimmer
authors.forename: Adam
authors.initials: A
authors.lastname: McConville
authors.forename: Alex
authors.initials: A
authors.lastname: Malin
authors.forename: Richard
authors.initials: R
authors.lastname: Jackson
authors.forename: Paul
authors.initials: P
authors.lastname: Collins
authors.forename: Chris
authors.initials: C
authors.lastname: Probert
authors.forename: Martyn
authors.initials: M
authors.lastname: Dibb
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Rhodes
mesh_terms: D000328:Adult; D019540:Area Under Curve; D002097:C-Reactive Protein / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000097:blood / Q000188:drug therapy / Q000517:prevention & control*; D003424:Crohn Disease / Q000097:blood / Q000188:drug therapy / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012074:Remission Induction; D057566:Self Report; D012720:Severity of Illness Index
chemical_list: D039841:Leukocyte L1 Antigen Complex; D002097:C-Reactive Protein