Development and Testing of a New Simplified Endoscopic Mucosal Assessment for Crohn's Disease: The SEMA-CD

被引：18

作者：

Adler, Jeremy ^{[1
,2
]}

Eder, Sally J. ^{[2
]}

Gebremariam, Acham ^{[2
]}

French, Kelley Rose ^{[1
]}

Moncion, Ila ^{[1
]}

Singer, Andrew A. M. ^{[1
]}

Bass, Lee M. ^{[3
]}

Moran, Christopher J. ^{[4
]}

Picoraro, Joseph A. ^{[5
]}

Moses, Jonathan ^{[6
]}

Lewis, Jeffery D. ^{[7
]}

Sandberg, Kelly C. ^{[8
]}

Mar, Shuemein J. ^{[1
]}

Ebach, Dawn R. ^{[9
]}

Saeed, Shehzad A. ^{[8
]}

Rosh, Joel R. ^{[10
]}

Neef, Haley C. ^{[1
]}

Kaplan, Jess L. ^{[4
]}

Goyal, Alka ^{[11
]}

del Rosario, J. Fernando ^{[12
]}

Zacur, George M. ^{[1
]}

机构：

[1] Univ Michigan, Div Pediat Gastroenterol, CS Mott Childrens Hosp, Michigan Med, Ann Arbor, MI 48109 USA

[2] Univ Michigan, Susan B Meister Child Hlth Evaluat & Res Ctr, Michigan Med, Ann Arbor, MI 48109 USA

[3] Northwestern Univ, Feinberg Sch Med, Ann & Robert H Lurie Childrens Hosp Chicago, Chicago, IL 60611 USA

[4] Harvard Med Sch, MassGen Hosp Children, Boston, MA 02115 USA

[5] Columbia Univ, Irving Med Ctr, New York, NY USA

[6] Rainbow Babies & Childrens Hosp, 2101 Adelbert Rd, Cleveland, OH 44106 USA

[7] GI Care Kids, Atlanta, GA USA

[8] Wright State Univ, Dayton Childrens Hosp, Dayton, OH 45435 USA

[9] Univ Iowa Stead Family Childrens Hosp, Iowa City, IA USA

[10] Goryeb Childrens Hosp Atlantic Hlth, Morristown, NJ USA

[11] Univ Missouri, Childrens Mercy Kansas City, Kansas City, MO 64110 USA

[12] Nemours Alfred I duPont Hosp Children, Wilmington, DE USA

来源：

INFLAMMATORY BOWEL DISEASES | 2021年 / 27卷 / 10期

关键词：

colonoscopy; mucosal improvement; disease activity; pediatric; INFLAMMATORY-BOWEL-DISEASE; CLINICAL REMISSION; INDUCTION THERAPY; MANAGEMENT; VALIDATION; INFLIXIMAB; SEVERITY; OUTCOMES; TARGETS; SCORE;

D O I：

10.1093/ibd/izaa307

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objectives: Endoscopic mucosal improvement is the gold standard for assessing treatment efficacy in clinical trials of Crohn's disease. Current endoscopic indices are not routinely used in clinical practice. The lack of endoscopic information in large clinical registries limits their use for research. A quick, easy, and accurate method is needed for assessing mucosal improvement for clinicians in real-world practice. We developed and tested a novel simplified endoscopic mucosal assessment for Crohn's disease (SEMA-CD). Methods: We developed a 5-point scale for ranking endoscopic severity of ileum and colon based on Simple Endoscopic Score for Crohn's disease (SES-CD). Central readers were trained to perform SES-CD and SEMA-CD. Pediatric patients with Crohn's disease undergoing colonoscopy were enrolled. Video recordings of colonoscopies were de-identified and randomly assigned to blinded central readers. The SES-CD and SEMA-CD were scored for each video. The SES-CD was considered the validated standard for comparison. Correlation was assessed with Spearman rho, inter- and intrarater reliability with kappa statistics. Results: Fifty-seven colonoscopies were read a total of 212 times. Correlation between SEM A-CD and SES-CD was strong (rho = 0.98, P < 0.0001). Inter-rater reliability for SEMA-CD was 0.80, and intrarater reliability was 0.83. Central readers rated SEMA-CD as easier than SES-CD. Conclusion: The SEMA-CD accurately and reproducibly correlates with the standard SES-CD. Central readers viewed SEM A-CD as easier than SES-CD. Use of SEMA-CD in practice should enable collecting mucosal improvement information in large populations of patients. This will improve the quality of research that can be conducted in clinical registries. External validation is needed.

引用

页码：1585 / 1592

页数：8

共 35 条

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