TY - JOUR
T1 - A survey-based index was validated for measuring disease activity in inflammatory bowel disease. An evaluation study
AU - Timmer, Antje
AU - Kemptner, Daniela
AU - Takses, Angela
AU - Klebl, Frank
AU - Jöckel, Karl Heinz
PY - 2009/7
Y1 - 2009/7
N2 - Objective: Crohn's disease is a highly distressful chronic disorder, characterized by frequent relapses. A symptom-based disease activity index was developed for use in epidemiological research. Study Design and Setting: One hundred and six consecutive patients presenting to a tertiary referral hospital in Southern Germany in 2004-2005 participated in a questionnaire-based survey. As a reference standard, disease activity was assessed using a clinical index (Crohn's Disease Activity Index [CDAI], based on symptoms reported to physician, laboratory markers, and physician assessed signs). A linear regression equation was calculated based on the survey data on severity of symptoms (dependent variable: CDAI). Survey index scores (S-CDAI) were then calculated using the estimated coefficients for pain, stools, and general well-being in an independent data set. Results: S-CDAI and CDAI showed moderate agreement (kappa = 0.57 for relapse vs. remission). High activity (high S-CDAI) correlated negatively with high quality of life (disease specific: Short Inflammatory Bowel Disease Quality-of-Life Questionnaire; r = -0.67; generic: Short Form 36 physical summary score, r = -0.47). Test-retest reliability and sensitivity for change were good (intraclass correlation coefficient 0.81). Conclusion: A useful, valid, and reliable disease activity score was developed, which will facilitate meaningful survey research in this chronic disorder.
AB - Objective: Crohn's disease is a highly distressful chronic disorder, characterized by frequent relapses. A symptom-based disease activity index was developed for use in epidemiological research. Study Design and Setting: One hundred and six consecutive patients presenting to a tertiary referral hospital in Southern Germany in 2004-2005 participated in a questionnaire-based survey. As a reference standard, disease activity was assessed using a clinical index (Crohn's Disease Activity Index [CDAI], based on symptoms reported to physician, laboratory markers, and physician assessed signs). A linear regression equation was calculated based on the survey data on severity of symptoms (dependent variable: CDAI). Survey index scores (S-CDAI) were then calculated using the estimated coefficients for pain, stools, and general well-being in an independent data set. Results: S-CDAI and CDAI showed moderate agreement (kappa = 0.57 for relapse vs. remission). High activity (high S-CDAI) correlated negatively with high quality of life (disease specific: Short Inflammatory Bowel Disease Quality-of-Life Questionnaire; r = -0.67; generic: Short Form 36 physical summary score, r = -0.47). Test-retest reliability and sensitivity for change were good (intraclass correlation coefficient 0.81). Conclusion: A useful, valid, and reliable disease activity score was developed, which will facilitate meaningful survey research in this chronic disorder.
KW - Crohn's disease
KW - Epidemiologic methods
KW - Health status
KW - Questionnaires/standards
KW - Reproducibility of results
KW - Severity of illness index
UR - http://www.scopus.com/inward/record.url?scp=67349280653&partnerID=8YFLogxK
U2 - 10.1016/j.jclinepi.2008.07.020
DO - 10.1016/j.jclinepi.2008.07.020
M3 - Article
SN - 0895-4356
VL - 62
SP - 771
EP - 778
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
IS - 7
ER -