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

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World Journal of Gastroenterology 2021年第30期27卷 5100-5111页

作者： Amy Grant trudy lerer Anne M Griffiths JS Hyams Anthony Otley Division of Pediatrics IWK HealthHalifaxNS B3K6R8Canada Division of Research Connecticut Children's Medical CenterHartfordCT 06106United States Division of Gastroenterology Hepatology and Nutrition The Hospital for Sick ChildrenTorontoON M5G1X8Canada Division of Gastroenterology Connecticut Children's Medical CenterHartfordCT 06106United States Division of Pediatrics Dalhousie UniversityHalifaxNS B3H4C3Canada

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(P<0.001 and P<0.05).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.

关键词： Crohn’s disease Pediatric Crohn’s disease activity index Patient reported outcome measurement Disease activity Clinical trials Pediatric

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