Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study

Tursi, Antonio; Brandimarte, Giovanni; Mario, F. Di; Annunziata, Maria Laura; Boiocchi, Mauro; Bianco, Maria Antonietta; Colucci, Raffaele; Conigliaro, Rita; Danese, Silvio; Bastiani, Rudi De; Elisei, Walter; Escalante, Ricardo; Faggiani, Roberto; Ferrini, Luciano; Forti, Giacomo; Latella, Giovanni; Graziani, Maria Giovanna; Oliveira, Ênio Chaves de; Papa, Alfredo; Penna, Antônio; Portincasa, Piero; Søreide, Kjetil; Spadaccini, A.; Usai, Paolo; Bonovas, Stefanos; Scarpignato, Carmelo; Picchio, Marcello; Lecca, P.G.; Zampaletta, Costantino; Cassieri, C.; Damiani, Alberto; Desserud, Kari F; Fiorella, Serafina; Landi, Rosario; Goni, Elisabetta; Lai, Maria Letizia; Pigò, Flavia; Rotondano, G.; Schiaccianoce, Giuseppe

doi:10.1177/2050640615617636

Cited by 38 publications

(32 citation statements)

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“…It subdivides patients as having three increasing score of severity: DICA 1, DICA 2, and DICA 3 (9). We found that this classification was able to predict the outcome of the disease according to DICA score severity in term of acute diverticulitis occurrence/recurrence and in term of surgery occurrence (10). Moreover, the same study found that only DICA 2 patients might benefit from a scheduled therapy during the follow-up in term of acute diverticulitis occurrence/recurrence and in term of surgery occurrence (10).…”

Section: Methodsmentioning

confidence: 90%

“…Moreover, elective operations for diverticulitis rose up to 29% in the same period, especially in younger people (73% in rates of surgery for those individuals) (19). We have recently found DICA endoscopic classification as predictor of the outcome of DD in term of prevention of acute diverticulitis occurrence/recurrence and in term of surgery occurrence prevention: DICA 1 patients were always at very low risk of complications, and DICA 3 patients were always at very high risk of complications, despite scheduled therapy (10). Scheduled treatments in order to prevent acute diverticulitis occurrence/recurrence and surgery occurrence seem to be appropriated only in DICA 2 patients, and the mesalazinebased and the association mesalazine/rifaximin are the only treatments significantly effective (10).…”

Section: Discussionmentioning

confidence: 99%

“…In particular, DICA 1 patients are always at lower risk and DICA 3 patients are always at higher risk of DD complication irrespective of scheduled treatment in order to prevent complications occurrence (10). Only DICA 2 patients seemed to have a significant benefit from a scheduled treatment during the follow-up, and only two types of treatments seemed to be effective (10).…”

Section: Introductionmentioning

confidence: 97%

“…We recently found that scheduled treatment of DICA 1 and DICA 3 patients did not significantly affect the occurrence of acute diverticulitis occurrence/recurrence and the prevention of surgery occurrence (10). In particular, DICA 1 patients are always at lower risk and DICA 3 patients are always at higher risk of DD complication irrespective of scheduled treatment in order to prevent complications occurrence (10). Only DICA 2 patients seemed to have a significant benefit from a scheduled treatment during the follow-up, and only two types of treatments seemed to be effective (10).…”

Section: Introductionmentioning

confidence: 98%

“…The recent Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification may be a useful tool (9). We recently found that scheduled treatment of DICA 1 and DICA 3 patients did not significantly affect the occurrence of acute diverticulitis occurrence/recurrence and the prevention of surgery occurrence (10). In particular, DICA 1 patients are always at lower risk and DICA 3 patients are always at higher risk of DD complication irrespective of scheduled treatment in order to prevent complications occurrence (10).…”

Section: Introductionmentioning

confidence: 99%

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Impact of diverticular inflammation and complication assessment classification on the burden of medical therapies in preventing diverticular disease complications in Italy

Tursi

Elisei

Picchio³

et al. 2017

Ann. Transl. Med.

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Background: Several treatments are currently advised to manage diverticular disease (DD) patients, but their impact on the burden of the disease is unknown. Our aim was to assess the economic analysis of using the recent Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the burden of medical therapies prescribed in preventing DD complications occurrence in Italy. Methods:We assessed retrospectively the cost/year of treatments in estimated DICA 1, DICA 2 and DICA 3 population. Analysis of diverticulosis prevalence was estimated according to data population provided by Italian Institute of Statistics (ISTAT). Cost of treatments calculated according to data on drugs' consumption collected during the DICA study.Results: We estimated that >8 million of Italian people >60 years may have diverticulosis, and that about 75% of diverticular population are on DICA 1, about 30% on DICA 2, and about 13% on DICA 3. We estimated that >387 million of euros could be spent in DICA 1 population, >203 million of euros in DICA 2 population, and >88 million of euros in DICA 3 population. Since medical treatments did not show any significant advantage when treating DICA 1 and DICA 3 people in terms of prevention of acute diverticulitis occurrence/recurrence and surgery occurrence, we can estimated that >475 million of euros could be spent in Italy without any significant benefit in preventing DD complications occurrence.Conclusions: DICA endoscopic classification may have a significant impact on the burden of DD in Italy, because it helps to select DD people who effectively need treatments in terms of prevention of acute diverticulitis occurrence/recurrence and surgery occurrence.

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Section: Methodsmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%