Predicting the Crohn's disease activity index from the Harvey-Bradshaw Index. 2006

William R Best
Midwest Center for Health, Services and Policy Research, Edward Hines Jr VA Hospital, Hines, Illinois, USA. william.best@va.gov

BACKGROUND The Crohn's Disease Activity Index (CDAI) was developed in the 1970s to assess the degree of illness in individuals with Crohn's disease and has since been used widely in clinical trials of the condition. The Harvey-Bradshaw Index (HBI) is a simplification of the CDAI, designed to make data collection and computation easier. It is purported, on the basis of a 0.93 correlation coefficient, to give "essentially the same information." However, correlation is an incomplete way to assess sameness, and this study aimed to develop a method for predicting CDAI from HBI values, including relevant prediction limits. METHODS Data used in developing both indexes were combined. Single visits of 224 patients with Crohn's disease were plotted on a scattergram. HBI values seen were integers from 0 through 19. Mean and standard deviation of CDAI were determined for each HBI value that included a sufficient number of patients. Standard deviation of CDAI showed a linear increase with increasing HBI. Therefore, regression of CDAI on HBI was weighted on the inverse of the estimated CDAI standard deviation. RESULTS Regression predicted a 27-CDAI-unit increase for each HBI unit. Calculated 95% prediction limits were almost straight, diverging lines, bracketing 95% of observations. A table gives central tendency and 95% prediction limits of CDAI for any HBI, as well as key clinical benchmarks. CONCLUSIONS There is a good but far from perfect relationship between CDAI and HBI. CDAI is preferred for clinical trials; HBI is easier to use.

UI MeSH Term Description Entries
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D003424 Crohn Disease A chronic transmural inflammation that may involve any part of the DIGESTIVE TRACT from MOUTH to ANUS, mostly found in the ILEUM, the CECUM, and the COLON. In Crohn disease, the inflammation, extending through the intestinal wall from the MUCOSA to the serosa, is characteristically asymmetric and segmental. Epithelioid GRANULOMAS may be seen in some patients. Colitis, Granulomatous,Enteritis, Granulomatous,Enteritis, Regional,Ileitis, Regional,Ileitis, Terminal,Ileocolitis,Crohn's Disease,Crohn's Enteritis,Inflammatory Bowel Disease 1,Regional Enteritis,Crohns Disease,Granulomatous Colitis,Granulomatous Enteritis,Regional Ileitides,Regional Ileitis,Terminal Ileitis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012720 Severity of Illness Index Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder. Illness Index Severities,Illness Index Severity
D018450 Disease Progression The worsening and general progression of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. Clinical Course,Clinical Progression,Disease Exacerbation,Exacerbation, Disease,Progression, Clinical,Progression, Disease

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