RSS-Feed abonnieren
DOI: 10.1055/s-0031-1291385
Validation of the Capsule Endoscopy Crohn’s Disease Activity Index (CECDAI or Niv score): a multicenter prospective study
Publikationsverlauf
submitted 10. März 2011
accepted after revision: 27. Juli 2011
Publikationsdatum:
28. November 2011 (online)
![](https://www.thieme-connect.de/media/endoscopy/201201/lookinside/thumbnails/10.1055-s-0031-1291385-1.jpg)
Background and study aims: The Capsule Endoscopy Crohn’s Disease Activity Index (CECDAI or Niv score) was devised to measure mucosal disease activity using video capsule endoscopy (VCE). The aim of the current study was to prospectively validate the use of the scoring system in daily practice.
Methods: This was a multicenter, double-blind, prospective, controlled study of VCE videos from 62 consecutive patients with isolated small-bowel Crohn’s disease. The CECDAI was designed to evaluate three main parameters of Crohn’s disease: inflammation (A), extent of disease (B), and stricture (C), in both the proximal and distal segments of the small bowel. The final score was calculated by adding the two segmental scores: CECDAI = ([A1 × B1] + C1) + ([A2 × B2] + C2). Each examiner in every site interpreted 6 – 10 videos and calculated the CECDAI. The de-identified CD-ROMs were then coded and sent to the principal investigator for CECDAI calculation.
Results: The cecum was reached in 72 % and 86 % of examinations, and proximal small-bowel involvement was found in 56 % and 62 % of the patients, according to the site investigators and principal investigator, respectively. Significant correlation was demonstrated between the calculation of the CECDAI by the individual site investigators and that performed by the principal investigator. Overall correlation between endoscopists from the different study centers was good, with r = 0.767 (range 0.717 – 0.985; Kappa 0.66; P < 0.001). There was no correlation between the CECDAI and the Crohn’s Disease Activity Index or the Inflammatory Bowel Disease Quality of Life Questionnaire or any of their components.
Conclusion: A new scoring system of mucosal injury in Crohn’s disease of the small intestine, the CECDAI, was validated. Its use in controlled trials and/or regular follow-up of these patients is advocated.
-
References
- 1 Whelan G. Epidemiology of inflammatory bowel disease. Med Clin North Am 1990; 74: 1-12
- 2 Goldberg HI, Caruthers jr SB, Nelson JA et al. Radiographic findings of the National Cooperative Crohn’s Disease Study. Gastroenterology 1979; 77: 1-37
- 3 Sandborn W, Feagan B, Hanauer S et al. A review of activity indices and efficacy endpoints for clinical trials of medical therapy in adults with Crohn’s disease. Gastroenterology 2002; 122: 512-530
- 4 Naber A, de Jong D. Assessment of disease activity in inflammatory bowel disease: relevance for clinical trials. Neth J of Med 2003; 61: 105-110
- 5 Granlek IM, Defranchis R, Seidman E et al. Development of a capsule endoscopy scoring index for small bowel mucosal inflammatory change. Alim Pharm Ther 2008; 27: 146-154
- 6 Gal E, Geller A, Fraser G et al. Assessment of a new simple capsule endoscopy Crohn’s disease activity index (CECDAI). Dig Dis Sci 2008; 53: 1933-1937
- 7 Daperno M, D'Haens G, Van Assche G et al. Development and validation of a new, simplified endoscopic activity score for Crohn’s disease: the SES-CD. Gastrointest Endosc 2004; 60: 505-512
- 8 Rutgeerts P, Geboes K, Van-Trappen G et al. Natural history of recurrent Crohn’s disease at the ileocolonic anastomosis after curative surgery. Gut 1984; 25: 665-672
- 9 Triester SL, Leighton JA, Leontiadis GI et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with non-stricturing small bowel Crohn’s disease. Am J Gastroenterol 2006; 101: 954-964
- 10 Goldstein JL, Eisen GM, Lewis B et al. Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo. Clin Gastroenterol and Hepatol 2005; 3: 133-141
- 11 Shivananda S, Mayberry JF. Epidemiology of inflammatory bowel disease. Curr Opin Gastroenterol 1993; 9: 560-565
- 12 Best W, Becktel JM, Singleton JW et al. Development of a Crohn’s disease activity index. Gastroenterology 1976; 70: 439-444
- 13 Guyatt G, Mitchell A, Irvine EJ et al. A new measure of health status for clinical trials in inflammatory bowel disease. Gastroenterology 1989; 96: 804-810
- 14 Harvey RF, Bradshaw JM. A simple index of Crohn’s disease activity. Lancet 1980; 1: 514-514
- 15 Costamagna G, Shah S, Riccioni M et al. A prospective trial comparing small bowel radiographs and video capsule endoscopy for suspected small bowel disease. Gastroenterology 2002; 123: 999-1005
- 16 Denis AM, Reenaers C, Fontaine F et al. Assessment of endoscopic activity index and biological inflammatory markers in clinically active Crohn’s disease with normal C-reactive protein serum level. Inflamm Bowel Dis 2007; 13: 1100-1105
- 17 Landi B, Anh TN, Cortot A. (GETAID) et al. Endoscopic monitoring of Crohn’s disease treatment: a prospective randomized clinical trial. Gastroenterology 1992; 102: 1647-1653
- 18 Cellier C, Sahmoud T, Froguel E et al. Correlations between clinical activity, endoscopic severity, and biological parameters in colonic or ileocolonic Crohn’s disease. A prospective multicenter study of 121 cases. Gut 1994; 35: 231-235
- 19 Minderhoud IM, Oldenburg B, Wismeijer JA et al. IBS-like symptoms in patients with inflammatory bowel disease in remission: relationships with quality of life and coping behaviour. Dig Dis Sci 2004; 49: 469-474
- 20 Zimmerman J. Extraintestinal symptoms in irritable bowel syndrome and inflammatory bowel diseases: nature, severity, and relationship to gastrointestinal symptoms. Dig Dis Sci 2003; 48: 743