Abstract

Objective: Optimal management of the Inflammatory Bowel Diseases (IBD) aims for low levels of inflammation to reduce complication rates and disease burden. Scoring systems have been developed to monitor disease but most have not been validated or have shortcomings that limit their practical use. Our aim was to compare two patient related outcome scoring systems with established and validated tools to estimate disease severity in patients with IBD. Materials and Methods: Consecutive patients with either Crohn's disease or ulcerative colitis were recruited from outpatient clinics. Depending on their disease, patients were ask to complete the Crohn's Disease Activity Index (CDAI), short Crohn's Disease Activity Index (sCDAI), Simple Chronic Colitis Activity Index (SCCAI) and the Dudley Intestinal Symptom Questionnaire (DISQ). All patients had bloods taken for a full blood count and a faecal sample for measurement of faecal calprotectin (FCP). Results: Ninety-one patients (47 CD, 44 UC) were recruited for this prospective analysis. In CD, the CDAI, sCDAI and IBDQ correlated well with each other. Limited agreement was demonstrated with the DISQ. Neither scoring system correlated well with faecal calprotectin. In UC patients there was limited agreement between the SCCAI and the DISQ but better correlation with the IBDQ. No correlation was seen with faecal calprotectin. Conclusion: There was some correlation between the clinical indices, more so in UC than CD but neither correlated with FCP. It remains difficult to use patient-reported outcomes to measure mucosal inflammation and determine remission.

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