555
Journal of Crohn's and Colitis, 2019, 555–563
doi:10.1093/ecco-jcc/jjy196
Advance Access publication November 24, 2018
Original Article
Copyright © 2018 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved.
For permissions, please email: journals.permissions@oup.com
Original Article
Development and Validation of a Patient-
reported Score to Screen for Mucosal
Infammation in Infammatory Bowel Disease
Marin J. de Jong,
a,b
Danielle Roosen,
a
Juliette H. R. J. Degens,
a
Tim R. A. van den Heuvel,
a,b
Marielle Romberg-Camps,
c
W. Hameeteman,
a
Alexander G. L. Bodelier,
d
Igor Romanko,
e
Milan Lukas,
e
Bjorn Winkens,
f,i
Tineke Markus,
g
Ad A. M. Masclee,
a,b
Astrid van Tubergen,
h,i
Daisy M. A. E. Jonkers,
a,b
Marie J. Pierik
a,b
a
Maastricht University Medical Center+, Department Gastroenterology and Hepatology, Maastricht, The
Netherlands
b
Maastricht University Medical Center+, NUTRIM – School for Nutrition and Translational Research
in Metabolism, Maastricht, The Netherlands
c
Zuyderland Medical Center, Department of Gastroenterology,
Geriatrics, Internal and Intensive Care Medicine [Co-MIK], Sittard-Geleen, The Netherlands
d
Amphia Hospital Breda,
Department of Gastroenterology and Hepatology, Breda, The Netherlands
e
Clinical Research Center for Infammatory
Bowel Diseases IBD Center ISCARE, Prague, Czech Republic
f
Maastricht University Medical Center, Department
of Methodology and Statistics, Maastricht, The Netherlands
g
CCUVN, Woerden, The Netherlands
h
Maastricht
University Medical Center+, Department of Rheumatology, Maastricht, The Netherlands
i
Maastricht University
Medical Center+, CAPHRI Care and Public Health Research Institute, Maastricht, The Netherlands
Corresponding author: M. J. Pierik, MD, PhD, Department of Gastroenterology and Hepatology, Maastricht University
Medical Center +, Maastricht, The Netherlands. Tel.: +31 43 38 75 021; email: M.pierik@mumc.nl
Abstract
Background and Aims: Patient-reported outcome measures [PROMs] assessing infammatory
bowel disease [IBD] activity are of interest for monitoring in clinical practice, telemedicine
systems, or trials. Different PROMs for follow-up of disease activity are available; however, none
was developed with endoscopy as gold standard. The objective of this study was to develop and
validate a PROM to predict endoscopic disease activity, following the recommendations of the
Food and Drug Administration.
Methods: During development, 178 IBD patients undergoing a colonoscopy were asked to fll out
13 clinical questions derived from the literature. During endoscopy, infammation was assessed
with the simplifed endoscopic score for Crohn’s disease [CD] and the Mayo endoscopic subscore
for ulcerative colitis [UC]. Based on correlation with endoscopic infammation, questions were
reduced to a total of six for CD and fve for UC. The newly developed Monitor IBD At Home
questionnaire [MIAH] was validated in an independent cohort of 135 CD and 131 UC patients.
Additionally, diagnostic accuracy of the MIAH combined with a calprotectin home test [CHT] was
assessed.
Results: The MIAH-CD includes questions on rectal bleeding, mucus, stool frequency, urgency,
fatigue, and patient-reported disease activity.The MIAH-UC contains items on rectal bleeding, stool
frequency, urgency, abdominal pain, and patient-reported disease activity. Both questionnaires
showed to be valid, reliable, and responsive to changes. The MIAH and CHT combined had a
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