Short pediatric Crohn's disease activity index for quality improvement and observational research

Michael D. Kappelman, Wallace V. Crandall, Richard B. Colletti, Anthony Goudie, Ian H. Leibowitz, Lynn Duffy, David E. Milov, Sandra C. Kim, Bess T. Schoen, Ashish S. Patel, John Grunow, Evette Larry, Gerry Fairbrother, Peter Margolis

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Background: Practical and objective instruments to assess pediatric Crohn's disease (CD) activity are required for observational research and quality improvement. The objectives were: 1) to determine the feasibility of completing the Pediatric Crohn's Disease Activity Index (PCDAI) and the Abbreviated PCDAI (APCDAI); and 2) to create a Short PCDAI by retaining and reweighting the most practical and informative components. Methods: Physicians in the ImproveCareNow Collaborative for pediatric inflammatory bowel disease (IBD) were asked to record components of the PCDAI and assign a Physician Global Assessment (PGA) of disease severity at each patient encounter. We assessed the feasibility of the PCDAI, the APCDAI, and the individual index components by determining the proportion of visits in which data were recorded. We created a short index by retaining and reweighting components of the PCDAI completed in ≥80% of visits. The feasibility of the Short PCDAI and its ability to discriminate between PGA categories were evaluated using descriptive statistics. Results: This study population included 1355 subjects with CD (6373 visits). The PCDAI and APCDAI were complete in 16.7% and 44.1% of visits, respectively. A Short PCDAI, including general well-being, abdominal pain, stools, weight, abdominal exam, and extraintestinal manifestations were completed in 66.5% of visits. The correlation between the Short PCDAI and PGA was similar to that of the PCDAI (r = 0.60, P < 0.001 versus 0.61, P < 0.001). Conclusions: The Short PCDAI is a practical and valid tool to measure pediatric CD activity. Its use should facilitate quality improvement and observational research.

Original languageEnglish (US)
Pages (from-to)112-117
Number of pages6
JournalInflammatory Bowel Diseases
Volume17
Issue number1
DOIs
StatePublished - Jan 2011

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Quality Improvement
Research
Physicians
Pediatric Crohn's disease
Inflammatory Bowel Diseases
Crohn Disease
Abdominal Pain

Keywords

  • Crohn's disease
  • PCDAI
  • Pediatric Crohn's Disease Activity Index

ASJC Scopus subject areas

  • Gastroenterology
  • Immunology and Allergy

Cite this

Kappelman, M. D., Crandall, W. V., Colletti, R. B., Goudie, A., Leibowitz, I. H., Duffy, L., ... Margolis, P. (2011). Short pediatric Crohn's disease activity index for quality improvement and observational research. Inflammatory Bowel Diseases, 17(1), 112-117. https://doi.org/10.1002/ibd.21452

Short pediatric Crohn's disease activity index for quality improvement and observational research. / Kappelman, Michael D.; Crandall, Wallace V.; Colletti, Richard B.; Goudie, Anthony; Leibowitz, Ian H.; Duffy, Lynn; Milov, David E.; Kim, Sandra C.; Schoen, Bess T.; Patel, Ashish S.; Grunow, John; Larry, Evette; Fairbrother, Gerry; Margolis, Peter.

In: Inflammatory Bowel Diseases, Vol. 17, No. 1, 01.2011, p. 112-117.

Research output: Contribution to journalArticle

Kappelman, MD, Crandall, WV, Colletti, RB, Goudie, A, Leibowitz, IH, Duffy, L, Milov, DE, Kim, SC, Schoen, BT, Patel, AS, Grunow, J, Larry, E, Fairbrother, G & Margolis, P 2011, 'Short pediatric Crohn's disease activity index for quality improvement and observational research', Inflammatory Bowel Diseases, vol. 17, no. 1, pp. 112-117. https://doi.org/10.1002/ibd.21452
Kappelman MD, Crandall WV, Colletti RB, Goudie A, Leibowitz IH, Duffy L et al. Short pediatric Crohn's disease activity index for quality improvement and observational research. Inflammatory Bowel Diseases. 2011 Jan;17(1):112-117. https://doi.org/10.1002/ibd.21452
Kappelman, Michael D. ; Crandall, Wallace V. ; Colletti, Richard B. ; Goudie, Anthony ; Leibowitz, Ian H. ; Duffy, Lynn ; Milov, David E. ; Kim, Sandra C. ; Schoen, Bess T. ; Patel, Ashish S. ; Grunow, John ; Larry, Evette ; Fairbrother, Gerry ; Margolis, Peter. / Short pediatric Crohn's disease activity index for quality improvement and observational research. In: Inflammatory Bowel Diseases. 2011 ; Vol. 17, No. 1. pp. 112-117.
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abstract = "Background: Practical and objective instruments to assess pediatric Crohn's disease (CD) activity are required for observational research and quality improvement. The objectives were: 1) to determine the feasibility of completing the Pediatric Crohn's Disease Activity Index (PCDAI) and the Abbreviated PCDAI (APCDAI); and 2) to create a Short PCDAI by retaining and reweighting the most practical and informative components. Methods: Physicians in the ImproveCareNow Collaborative for pediatric inflammatory bowel disease (IBD) were asked to record components of the PCDAI and assign a Physician Global Assessment (PGA) of disease severity at each patient encounter. We assessed the feasibility of the PCDAI, the APCDAI, and the individual index components by determining the proportion of visits in which data were recorded. We created a short index by retaining and reweighting components of the PCDAI completed in ≥80{\%} of visits. The feasibility of the Short PCDAI and its ability to discriminate between PGA categories were evaluated using descriptive statistics. Results: This study population included 1355 subjects with CD (6373 visits). The PCDAI and APCDAI were complete in 16.7{\%} and 44.1{\%} of visits, respectively. A Short PCDAI, including general well-being, abdominal pain, stools, weight, abdominal exam, and extraintestinal manifestations were completed in 66.5{\%} of visits. The correlation between the Short PCDAI and PGA was similar to that of the PCDAI (r = 0.60, P < 0.001 versus 0.61, P < 0.001). Conclusions: The Short PCDAI is a practical and valid tool to measure pediatric CD activity. Its use should facilitate quality improvement and observational research.",
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