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Validation and Update of the Lémann Index to Measure Cumulative Structural Bowel Damage in Crohn's Disease
B. Pariente, J. Torres, J. Burisch, N. Arebi, B. Barberio, D. Duricova, P. Ellul, A. Goldis, I. Kaimakliotis, K. Katsanos, Ž. Krznaric, D. McNamara, N. Pedersen, S. Sebastian, M. Azahaf, P. Weimers, P. Lung, C. Lacognata, M. Horak, D....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, multicentrická studie, pozorovací studie, práce podpořená grantem, validační studie
Grantová podpora
K23 DK111995
NIDDK NIH HHS - United States
- MeSH
- Crohnova nemoc diagnostické zobrazování patologie chirurgie MeSH
- dospělí MeSH
- gastrointestinální endoskopie * MeSH
- kolonoskopie MeSH
- lidé MeSH
- magnetická rezonanční tomografie * MeSH
- metody pro podporu rozhodování * MeSH
- počítačová rentgenová tomografie MeSH
- prediktivní hodnota testů MeSH
- prospektivní studie MeSH
- průřezové studie MeSH
- reprodukovatelnost výsledků MeSH
- střeva diagnostické zobrazování patologie chirurgie MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- validační studie MeSH
- Geografické názvy
- City of New York MeSH
- Evropa MeSH
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.
American Gastroenterology Center Cyprus
Department of Gastroenterology Medical Division Hvidovre University Hospital Hvidovre Denmark
Department of Gastroenterology North Zealand University Hospital Capital Region Denmark
Department of Gastroenterology Slagelse Hospital Slagelse Denmark
Department of Gastroenterology University of Medicine Timișoara România
Department of Radiology Na Homolce Hospital Prague Czech Republic
Department of Radiology Tallaght University Hospital Dublin Ireland
Division of Gastroenterology Surgical Department Hospital Beatriz Ângelo Loures Portugal
Hepato Gastroenterology Department Claude Huriez Hospital University of Lille Lille France
Inflammatory Bowel Diseases Clinical and Research Center ISCARE a s Prague Czech Republic
Institute of Pharmacology 1st Faculty of Medicine Charles University Prague Czech Republic
Mater Dei Hospital Department of Medicine Division of Gastroenterology Msida Malta
Radiology Department Claude Huriez hospital University of Lille Lille France
Radiology Department St Mark's Hospital and Imperial College London United Kingdom
Radiology Unit University of Padova Padova Italy
TAGG Research Centre School of Medicine Trinity College Dublin Dublin Ireland
Citace poskytuje Crossref.org
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- $a Pariente, Benjamin $u Hepato-Gastroenterology Department, Claude Huriez Hospital, University of Lille, Lille, France. Electronic address: benjamin.pariente@chru-lille.fr
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