Development and validation of a new disease severity index: the Inflammatory Bowel Disease Index (IBDEX)

Abstract

Objective To develop, validate and apply a generic clinical severity index applicable to all adult patients with inflammatory bowel disease (IBD). Design A review of the literature and an expert focus group consultation were carried out in order to draw out relevant items from existing literature. The new index was called the IBD Index (IBDEX). Standard psychometric analysis was carried out. The construct validity was assessed against biochemical markers, clinical and endoscopic indices. The new index was completed again within 6 weeks to check responsiveness and reproducibility. Results IBDEX was used to assess 255 adult patients with IBD (125 with Crohn's disease and 130 with ulcerative colitis), and 64 patients were re-evaluated within 6 weeks. It had good internal consistency (Cronbach's α=0.79) and correlated very well with the Harvey Bradshaw Index (r=0.94), the Simple Clinical Colitis Activity Index (r=0.92), the Mayo Clinic Index (r=0.87) and the Simple Endoscopic Score (r=0.76), all with p values <0.05. IBDEX had a moderate but positive correlation with C reactive protein (r=0.51) and erythrocyte sedimentation rate (r=0.36) p values both <0.05. The test-retest reliability was good (intraclass correlation coefficient 0.97) and responsiveness ratio was 2.27. Conclusions IBDEX is the first properly validated Clinical Disease Severity Index in IBD. Our results showed that it is valid, reliable and reproducible and has the potential to be used in clinical practice.

White coat hypertension is another clinical characteristic of patients with inflammatory bowel disease: A cross-sectional study

“…Considering lower prevalence of traditional CV risk factors in IBD-WCH patients one could argue that WCH in IBD is not associated with higher CV risk and consecutively that high prevalence of WCH could not contribute to the observed higher CV risk in IBD patients. It was reported that WCH is associated with early vascular aging and two meta-analyses confirmed that subjects with WCH, both treated and untreated, have increased cf-PWV compared to the normotensive subjects [27,29,37,53,54] which was in line with our results. It was proposed that observed higher CV risk in WCH partly could be explained with higher PWV, i.e., higher arterial stiffness.…”

“…It was reported that WCH is associated with early vascular aging and two meta-analyses confirmed that subjects with WCH, both treated and untreated, have increased cf-PWV compared to the normotensive subjects [27,29,37,53,54] which was in line with our results. It was proposed that observed higher CV risk in WCH partly could be explained with higher PWV, i.e., higher arterial stiffness.…”

“…The activity of Chron´s disease and ulcerative colitis were assessed by Harvey–Bradshaw index and Truelove and Witts’ criteria, respectively. [37,38] We have enrolled 90 healthy age-sex matched and untreated control subjects which were recruited at family physician office during general medical examination to compare the incidence of WCH and PWV values with IBD group of patients. The protocol was approved by the hospital ethics committee (University Hospital Center Zagreb, number 02/21 AG), in accordance with the Helsinki Declaration, and all participants gave written informed consent.…”

Protocol for faecal microbiota transplantation in ulcerative colitis (FMTUC): a randomised feasibility study

“…Disease specific scores after treatment using IBDex severity scoring index, 32 Crohns and Ulcerative Colitis Questionnaire (CUCQ)-32 severity scoring index 33 and Mayo scoring system 34 …”

Highlights from this issue

“…To overcome this disconnect between research/regulatory practice and clinical practice, there is need for alternative measures of outcome, and thereafter definitions of response. Part of this process is the development of patient-reported outcomes, but in this edition of Frontline Gastroenterology Alrubaiy and colleagues propose a combination of end points—the IBDex©—from existing indices to complement such assessment 1. A challenge of these composite indices is to make them readily applicable in practice, and the authors propose achieving this with high validity and simplicity of scoring by recording over the last three days.…”