Disease Activity Indices for Pouchitis: A Systematic Review

Abstract Background Several indices exist to measure pouchitis disease activity; however, none are fully validated. As an initial step toward creating a validated instrument, we identified pouchitis disease activity indices, examined their operating properties, and assessed their value as outcome measures in clinical trials. Methods Electronic databases were searched to identify randomized controlled trials including indices that evaluated clinical, endoscopic, or histologic pouchitis disease activity. A second search identified studies that assessed the operating properties of pouchitis indices. Results Eighteen randomized controlled trials utilizing 4 composite pouchitis disease activity indices were identified. The Pouchitis Disease Activity Index (PDAI) was most commonly used (12 of 18; 66.7%) to define both trial eligibility (8 of 12; 66.7%), and outcome measures (12 of 12; 100%). In a separate search, 21 studies evaluated the operating properties of 3 pouchitis indices; 90.5% (19 of 21) evaluated validity, of which 42.1% (8 of 19) evaluated the construct validity of the PDAI. Criterion validity (73.7%; 14 of 19) was evaluated through correlation of the PDAI with fecal calprotectin (FCP; r = 0.188 to 0.71), fecal lactoferrin (r = 0.570 to 0.582), and C-reactive protein (CRP; r = 0.584). Two studies assessed correlation of the modified PDAI (mPDAI) with FCP (r = 0.476 and r = 0.565, respectively). Fair to moderate inter-rater reliability of the PDAI (k = 0.440) and mPDAI (k = 0.389) was reported in a single study. Responsiveness of the PDAI pre-antibiotic and postantibiotic treatment was partially evaluated in a single study of 12 patients. Conclusions Development and validation of a specific pouchitis disease activity index is needed given that existing instruments are not valid, reliable, or responsive.

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Baguan Therapy Is an Alternative in Treating Ankylosing Spondylitis: A Systematic Review Based on Existing Randomized Controlled Trials

Complementary Medicine Research ◽

10.1159/000494330 ◽

2019 ◽

Vol 26 (2) ◽

pp. 118-125

Author(s):

Fei Wang ◽

Zhong-Gu Tian ◽

Chao-Hui Lv ◽

Cheng-Wu Geng

Keyword(s):

Systematic Review ◽

Ankylosing Spondylitis ◽

Disease Activity ◽

Randomized Controlled Trials ◽

Activity Index ◽

Mean Difference ◽

Cochrane Library ◽

Controlled Trials ◽

Randomized Controlled

Background: The aim of this systematic review was to evaluate the evidence available on the effects of Baguan therapy for ankylosing spondylitis (AS) patients. Materials and Methods: The following databases were searched from their inception to August 2018: PubMed, Web of Science, AMED, Cochrane Library, Google, EMBASE, the China National Knowledge Infrastructure databases, Wanfang Data, CiNii, KoreaMed, and the Iranian Registry of Clinical Trials. Randomized controlled trials (RCTs), which assessed the effects of Baguan therapy for AS, were included in our review. The methodological quality of eligible studies was assessed by the Cochrane Collaboration’s tool. The RevMan 5.3 software was used for quantitative analysis of RCTs. Heterogeneity was assessed using I2 statistics. Results: Four studies were included in our review. The aggregated results indicated that Baguan therapy improved the treatment effect (risk ratio 1.21, 95% CI 1.10–1.34, p < 0.01) as well as physical function (Bath Ankylosing Spondylitis Functional Index) (mean difference –1.56, 95% CI –2.01 to –1.12, p < 0.01) and reduced disease activity (Bath Ankylosing Spondylitis Disease Activity Index) (mean difference –0.71, 95% CI –1.09 to –0.33, p < 0.01) in patients with AS. Conclusion: Due to the low quality of included trials, it is difficulty to draw the firm conclusion that Baguan therapy may have beneficial effects on AS.

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O-002 Evaluation of the Operating Properties of Candidate Patient Reported Outcomes for Use in Randomized Controlled Trials in Crohn’s Disease

Inflammatory Bowel Diseases ◽

10.1097/01.mib.0000438553.82572.42 ◽

2013 ◽

Vol 19 ◽

pp. S1-S2 ◽

Cited By ~ 1

Author(s):

Reena Khanna ◽

Geert DʼHaens ◽

Brian Feagan ◽

William Sandborn ◽

Margaret Vandervoort ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Randomized Controlled Trials ◽

Patient Reported Outcomes ◽

Controlled Trials ◽

Operating Properties ◽

Randomized Controlled ◽

Patient Reported

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Outcome domains and pain outcome measures in randomized controlled trials of interventions for postoperative pain in children and adolescents

European Journal of Pain ◽

10.1002/ejp.1313 ◽

2018 ◽

Vol 23 (2) ◽

pp. 389-396 ◽

Cited By ~ 5

Author(s):

Krste Boric ◽

Antonia Jelicic Kadic ◽

Matija Boric ◽

Melissa Zarandi-Nowroozi ◽

Dora Jakus ◽

...

Keyword(s):

Postoperative Pain ◽

Randomized Controlled Trials ◽

Children And Adolescents ◽

Outcome Measures ◽

Controlled Trials ◽

Randomized Controlled ◽

Pain Outcome

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Assessment of Ankylosing Spondylitis Activity During Pregnancy Using Different Disease Activity Indices

Rheumatology Science and Practice ◽

10.47360/1995-4484-2020-503-511 ◽

2020 ◽

Vol 58 (5) ◽

pp. 503-511

Author(s):

O. A. Krichevskaya ◽

Z. M. Gandaloeva ◽

S. I. Glukhova ◽

I. Yu. Skripkina ◽

A. B. Demina ◽

...

Keyword(s):

Back Pain ◽

Ankylosing Spondylitis ◽

Disease Activity ◽

Pregnant Women ◽

Activity Index ◽

Disease Activity Index ◽

Control Group ◽

Mean Values ◽

In Pregnancy ◽

Activity Indices

Objective: Assessment of ankylosing spondylitis activity patterns during pregnancy using BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) and ASDAS-CRP (Ankylosing Spondylitis Disease Activity Score — C-Reactive Protein) disease activity indices.Materials and methods. The prospective study included 36 pregnant women with AS (modified New York AS criteria, 1984). Patients’ mean age was 31.6±4.8 years, mean age at AS onset was 21.8±10.9, and disease duration 134.9±89.3 months. The control group included 30 healthy pregnant women with no history of back pain and arthritis, their mean age was 28.2±4.5 years. In the I trimester of pregnancy 10 (33.3%) As patients experienced back pain, while in the III trimester already 15 (50%) had back pain. Throughout pregnancy, the intensity of back pain in the I, II и III trimesters based on numeric scale was on average 1.9±0.9; 2.1±1.1 and 2.1±0.8. BASDAI and ASDAS-CRP were used to measure disease activity on gestational Weeks 10–11, 20–21 and 31–32. The time of conception BASDAI score was assessed retrospectively at the 1st visit.Results and discussion. BASDAI mean values at the time of conception and I, II и III trimesters of pregnancy were: 2.3±1.9; 2.8±1.72 (p<0,05 vs month of conception); 3.2±1.9 and 3.3±2.1 respectively. Mean ASDAS-CRP in the I, II и III trimesters were 1.9±0.7; 2.3±0.9 and 2.2±0,8 respectively. There was a trend to CRP increase in the II and III trimesters vs the I: median CRP values in the I, II and III trimesters were 5.7 [1.6; 6.2], 8.0 [2.1; 9.6] and 7.9 [2.0; 9.2] mg/L, respectively. Percentages of patients with high disease activity based on BASDAI scores in the I, II and III trimesters were 30.6; 34.3 and 34.3%; based on ASDAS-CRP — 36.1; 57.5 and 53%, respectively. Throughout pregnancy, BASDAI scores were lower in the control group than in AS patients (p<0.01). However, no differences were found when comparing BASDAI values of AS patients and healthy women with back pain during pregnancy. The level of fatigue did not differ between pregnant women with AS (median 5[3; 7] and 5[3; 6]) and healthy controls (5[3; 8] and 5[4; 6]) in the I and II trimesters, while in the III trimester, fatigue in healthy pregnant women (6[4; 8]) was more pronounced than in AS patients (5[3; 6], p=0.01). Throughout pregnancy, the intensity of back pain in AS patients and healthy pregnant women with back pain did not differ (p<0.05). Median pain intensity in the I, II and III trimesters was 3[2; 4]; 4[3; 5]; 3[2; 6] and 2,5[1; 4]; 3[2; 7]; 4[2; 6], respectively. A high (rs ≥0,7) correlation of all BASDAI components with the index itself in each trimester of pregnancy, except for joint pain in the month of conception, and in the I and III trimesters was established in the group of pregnant women with AS. The control group had quite high correlation (rs >0.7) of fatigue severity with the BASDAI index in the I and II trimesters of pregnancy and moderate correlation (rs >0.53) in the III trimester; as wells as moderate (rs >0.5-0.69) correlation between back pain and BASDAIConclusion. A trend towards increasing AS activity based on BASDAI and ASDAS-CRP scores and CRP levels was established for the first half of pregnancy. Later in pregnancy these increased values failed to return to normal until the end of gestation. The percentage of AS patients with highto-moderate disease activity throughout pregnancy was lower based on BASDAI score vs based on ASDAS-CRP. Some BASDAI components (fatigue and back pain) reflect not only the activity of AS, but also changes associated with physiological pregnancy. The BASDAI index requires adaptation for use in pregnancy

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Validation of the “German Inflammatory Bowel Disease Activity Index (GIBDI)”: An Instrument for Patient-Based Disease Activity Assessment in Crohn’s Disease and Ulcerative Colitis

Zeitschrift für Gastroenterologie ◽

10.1055/a-0605-4080 ◽

2018 ◽

Vol 56 (10) ◽

pp. 1267-1275 ◽

Cited By ~ 1

Author(s):

Angelika Hüppe ◽

Jana Langbrandtner ◽

Winfried Häuser ◽

Heiner Raspe ◽

Bernd Bokemeyer

Keyword(s):

Ulcerative Colitis ◽

Inflammatory Bowel Disease ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Disease Activity ◽

Bowel Disease ◽

Activity Index ◽

Disease Activity Index ◽

Inflammatory Bowel ◽

Activity Indices

Abstract Introduction Assessment of disease activity in Crohn’s disease (CD) and ulcerative colitis (UC) is usually based on the physician’s evaluation of clinical symptoms, endoscopic findings, and biomarker analysis. The German Inflammatory Bowel Disease Activity Index for CD (GIBDICD) and UC (GIBDIUC) uses data from patient-reported questionnaires. It is unclear to what extent the GIBDI agrees with the physicians’ documented activity indices. Methods Data from 2 studies were reanalyzed. In both, gastroenterologists had documented disease activity in UC with the partial Mayo Score (pMS) and in CD with the Harvey Bradshaw Index (HBI). Patient-completed GIBDI questionnaires had also been assessed. The analysis sample consisted of 151 UC and 150 CD patients. Kappa coefficients were determined as agreement measurements. Results Rank correlations were 0.56 (pMS, GIBDIUC) and 0.57 (HBI, GIBDICD), with p < 0.001. The absolute agreement for 2 categories of disease activity (remission yes/no) was 74.2 % (UC) and 76.6 % (CD), and for 4 categories (none/mild/moderate/severe) 60.3 % (UC) and 61.9 % (CD). The kappa values ranged between 0.47 for UC (2 categories) and 0.58 for CD (4 categories). Discussion There is satisfactory agreement of GIBDI with the physician-documented disease activity indices. GIBDI can be used in health care research without access to assessments of medical practitioners. In clinical practice, the index offers a supplementary source of information.

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