Validation and update of the Lémann index to measure cumulative structural bowel damage in Crohn’s disease (CROSBI ID 321449)
Prilog u časopisu | izvorni znanstveni rad | međunarodna recenzija
Podaci o odgovornosti
Pariente, Benjamin ; Torres, Joana ; Burisch, Johan ; Arebi, Naila ; Barberio, Brigida ; Duricova, Dana ; Ellul, Pierre ; Goldis, Adrian ; Kaimakliotis, Ioannis ; Katsanos, Konstantinos ; Krznaric, Željko ; McNamara, Deirdre ; Pedersen, Natalia ; Sebastian, Shaji ; Azahaf, Mustapha ; Weimers, Petra ; Lung, Philip ; Lacognata, Carmelo ; Horak, Martin ; Christodoulou, Dimitrios ; Domislovic, Viktor ; Murphy, Ian ; Lambert, Jérôme ; Ungaro, Ryan ; Colombel, Jean-Frédéric ; Mary, Jean-Yves
engleski
Validation and update of the Lémann index to measure cumulative structural bowel damage in Crohn’s disease
Background & aims: The Lémann Index is a tool measuring cumulative structural bowel damage in Crohn's disease (CD). We reported on its validation and updating. Methods: This was an international, multicenter, prospective, cross-sectional observational study. At each center, 10 inclusions, stratified by CD duration and location, were planned. For each patient, the digestive tract was divided into 4 organs, upper tract, small bowel, colon/rectum, anus, and subsequently into segments, explored systematically by magnetic resonance imaging and by endoscopies in relation to disease location. For each segment, investigators retrieved information on previous surgical procedures, identified predefined strictures and penetrating lesions of maximal severity (grades 1-3) at each organ investigational method (gastroenterologist and radiologist for magnetic resonance imaging), provided segmental damage evaluation ranging from 0.0 to 10.0 (complete resection). Organ resection-free cumulative damage evaluation was then calculated from the sum of segmental damages. Then investigators provided a 0- 10 global damage evaluation from the 4-organ standardized cumulative damage evaluations. Simple linear regressions of investigator damage evaluations on their corresponding Lémann Index were studied, as well as calibration plots. Finally, updated Lémann Index was derived through multiple linear mixed models applied to combined development and validation samples. Results: In 15 centers, 134 patients were included. Correlation coefficients between investigator damage evaluations and Lémann Indexes were >0.80. When analyzing data in 272 patients from both samples and 27 centers, the unbiased correlation estimates were 0.89, 0, 97, 0, 94, 0.81, and 0.91 for the 4 organs and globally, and stable when applied to one sample or the other. Conclusions: The updated Lémann Index is a well- established index to assess cumulative bowel damage in CD that can be used in epidemiological studies and disease modification trials.
bowel damage ; Crohn’s Disease ; Lémann index ; validation
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Podaci o izdanju
161 (3)
2021.
853-864E13
objavljeno
0016-5085
1528-0012
10.1053/j.gastro.2021.05.049
Povezanost rada
Kliničke medicinske znanosti