For the comparative study, 66 ulcerative colitis patients with scheduled lower endoscopy appointments at the U-M Health System's Medical Procedures Unit were evaluated using two indices requiring endoscopy and two non-endoscopic measures of disease activity.
The patient sample, gathered over a five-month period, included both very ill inpatients and healthy outpatients with less active disease, a range that is representative of patients participating in clinical trials.
Prior to their scheduled endoscopy, patients completed a 50-question survey and provided a blood sample to collect data to compare the invasive indices (the St. Marks's Index and the Ulcerative Colitis Disease Activity Index) and the noninvasive indices (the Simple Clinical Colitis Activity Index and the Seo Index).
As part of the St. Mark's and the UCDAI measures, patients undergo a physician assessment and endoscopy, while the SCCAI and the Seo index use a six-question symptom survey and a two-question survey with blood tests, respectively, to measure ulcerative colitis.
To learn how much information endoscopies contribute to the measurement of disease activity, each endoscopic index was analyzed to determine how well it predicted disease activity with and without the endoscopic item. The prediction of disease activity was nearly as good (only 3 percent less accurate) without the endoscopic information. The St. Mark's Index and the UCDAI endoscopy items correlated with patient-reported stool frequency and stool blood, which are already measured in the indices through survey questions.
These findings suggest endoscopy is not a necessary component to determine disease activity and that less expensive, noninvasive indices may be reasonable alternatives for measuring disease activity for ulcerative coli
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25-Feb-2005