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Systematic Review of the Clinical Disease Severity Indices for Inflammatory Bowel Disease

Alrubaiy, Laith MD, MRCP*; Rikaby, Ibtihal MPharm; Sageer, Mohamed MD; Hutchings, Hayley Anne PhD*; Williams, John Gordon FRCP, CBE*

doi: 10.1097/MIB.0000000000000438
Clinical Review Articles

Background: Clinical disease severity indices are increasingly being used in choosing treatment and monitoring the response of patients with inflammatory bowel disease (IBD). The aim of this study was to systematically review the clinical disease severity indices in IBD and to appraise their measurement properties and methodological quality.

Methods: We searched the MEDLINE, Embase, and PsycINFO databases for original articles describing the development and/or evaluation of one or more of the measurement properties of clinical disease severity indices used in IBD. We assessed these properties (e.g., internal consistency, reliability, validity, responsiveness) using a standardized checklist.

Results: We examined the full text of 142 articles that we deemed potentially eligible and identified 22 clinical disease severity indices in IBD. No clinical disease index has met all the required measurement properties. All of the validation studies were not descriptive enough to allow assessment of their methodology.

Conclusions: Although commonly used in multiple clinical trials, none of the clinical disease severity indices in IBD had all the required measurement properties. Further validation studies are required.

Article first published online 11 May 2015.

*Patient & Population Health and Informatics Research, College of Medicine, Swansea University, Swansea, United Kingdom;

Cardiff and Vale University Health Board, Heath Park, Cardiff, United Kingdom; and

Lahey Hospital & Medical Center, Burlington, Massachusetts.

Reprints: Laith Alrubaiy, MD, MRCP, College of Medicine, Swansea University, Room 220, Grove Building, Swansea SA2 8PP, United Kingdom (e-mail:

Supported by the Welsh Clinical Academic Training (WCAT) scheme and its collaboration between Swansea University, Wales Deanery, and the Welsh Government.

The authors have no conflicts of interest to disclose.

Received February 12, 2015

Accepted March 13, 2015

© Crohn's & Colitis Foundation of America, Inc.
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