Assessing disease activity using the pediatric Crohn’s disease activity index:Can we use subjective or objective parameters alone?

作     者：Amy Grant Trudy Lerer Anne M Griffiths JS Hyams Anthony Otley 

作者机构：Division of PediatricsIWK HealthHalifaxNS B3K6R8Canada Division of ResearchConnecticut Children's Medical CenterHartfordCT 06106United States Division of Gastroenterology Hepatology and NutritionThe Hospital for Sick ChildrenTorontoON M5G1X8Canada Division of GastroenterologyConnecticut Children's Medical CenterHartfordCT 06106United States Division of PediatricsDalhousie UniversityHalifaxNS B3H4C3Canada 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2021年第27卷第30期

页      面：5100-5111页

核心收录：

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

基　　金：Amgen Bristol-Myers Squibb, BMS Roche AbbVie Janssen Canada 

主　　题：Crohn’s disease Pediatric Crohn’s disease activity index Patient reported outcome measurement Disease activity Clinical trials Pediatric 

摘      要：BACKGROUND The pediatric Crohn’s disease activity index(PCDAI)is used as a standard tool to assess disease activity in clinical trials for pediatric Crohn’s *** To examine which items on the PCDAI drive assessment of disease activity,and how subgroups of subjective and objective items reflect change in disease state over *** Selective raw data from three prospectively collected datasets were combined,including 703 children with full PCDAI data at baseline,at 3-mo(Q1,n=670),and 1-year(Q4,n=474).Change in individual PCDAI scores from baseline to Q1 and to Q4 were examined using the non-weighted *** Abdominal pain,well-being,weight,and stooling had the highest change scores over *** indicators including albumin,abdominal exam,and height velocity *** scores for well-being and abdominal exam did not explain significant variance at Q1 but were significant predictors at Q4(P0.001 and P0.05).Subjective and objective subgroups of items predicted less variance(18%and 22%)on total PCDAI scores at Q1 and Q4 compared to the full PCDAI,or a composite scale(both 32%)containing significant *** Although subjective items on the PCDAI change the most over time,the full PCDAI or a smaller composite of items including a combination of subjective and objective components classifies disease activity better than a subgroup of either subjective or objective items *** on subjective or objective items as stand-alone proxies for disease activity measurement could result in misclassification of disease state.