BACKGROUND AND AIMS: Histological scoring plays a key role in the assessment of disease activity in ulcerative colitis [UC] and is also important in Crohn´s disease [CD]. Currently, there is no common scoring available for UC and CD. We aimed to validate the Inflammatory Bowel Disease [IBD]-Distribution [D], Chronicity [C], Activity [A] score [IBD-DCA score] for histological disease activity assessment in IBD. METHODS: Inter- and intra-rater reliability were assessed by 16 observers on biopsy specimens from 59 patients with UC and 25 patients with CD. Construct validity and responsiveness to treatment were retrospectively evaluated in a second cohort of 30 patients. RESULTS: Inter-rater reliability was moderate to good for the UC cohort (intraclass correlation coefficients [ICCs] = 0.645, 0.623, 0.767 for D, C, and A, respectively) and at best moderate for the CD cohort [ICC = 0.690, 0.303, 0.733 for D, C, and A, respectively]. Intra-rater agreement ranged from good to excellent in both cohorts. Correlation with the Nancy Histological Index [NHI] was moderate and strong with the Simplified Geboes Score [SGS] and a Visual Analogue Scale [VAS], respectively. Large effect sizes were obtained for all three parameters. External responsiveness analysis revealed correlated changes between IBD-DCA score and NHI, SGS and VAS. CONCLUSIONS: The IBD-DCA score is a simple histological activity score for UC and CD, agreed and validated by a large group of IBD specialists. It provides reliable information on treatment response. Therefore, it has potential value for use in routine diagnostics as well as clinical studies.

Charité Universitätsmedizin Berlin Humboldt Universität zu Berlin and Berlin Institute of Health Berlin Germany

Department of Gastroenterology Humanitas Research Hospital Rozzano Milan Italy

Department of Gastroenterology Nancy University Hospital Lorraine University Vandoeuvre France

Department of Internal Medicine 1 Gastroenterology Hepatology Endocrinology and Metabolism Medical University Innsbruck Innsbruck Austria

Department of Medicine and Deutsches Zentrum Immuntherapie DZI University Hospital Friedrich Alexander University Erlangen Germany

Department of Nephropathology Institute of Pathology Friedrich Alexander University Erlangen Nürnberg Erlangen Germany

Department of Pathology and Centre for Colorectal Disease St Vincent´s University Hospital and University College Dublin Ireland

Department of Pathology Karolinska Institute and University Hospital Stockholm Sweden

Department of Pathology Moffitt Cancer Center Tampa FL USA

Department of Pathology Radboud University Medical Centre Nijmegen The Netherlands

Department of Pathology School for Oncology and Developmental Biology Maastricht University Medical Center Maastricht The Netherlands

Department of Pathology Spedali Civili Brescia Brescia Italy

Department of Pathology University of Michigan Ann Arbor MI USA

Fingerland Department of Pathology Charles University Faculty of Medicine and University Hospital Hradec Králové Czech Republic

Institute for Legal Medicine Section Pathology University Hospital Jena Germany

Institute of Pathology Friedrich Alexander University Erlangen Germany

Institute of Pathology Klinikum Bayreuth GmbH Bayreuth Germany

Institute of Pathology Patho im Zentrum St Pölten Austria

Institute of Pathology Tirol Kliniken Innsbruck Austria

Institute of Pathology University of Bern Bern Switzerland

Medical Department [Gastroenterology Infectiology Rheumatology] Charité Universitätsmedizin Berlin Humboldt Universität zu Berlin and Berlin Institute of Health Berlin Germany

Pathology and Data Analytics Leeds Institute of Medical Research at St James's University of Leeds Leeds UK

Pathology and Laboratory Medicine Mount Sinai Hospital University of Toronto Toronto ON Canada

Pathology Department Saint Antoine Hospital Pierre et Marie Curie University Paris France

Transregio 241 IBDome Consortium Erlangen Berlin Germany

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J Crohns Colitis. 2021 Oct 7;15(10):1603-1604. doi: 10.1093/ecco-jcc/jjab083. PubMed

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Histopathological assessment of the microscopic activity in inflammatory bowel diseases: What are we looking for?