1. Development and validation of a scoring index to predict the presence of lesions in capsule endoscopy in patients with suspected Crohn’s disease of the small bowel
- Author
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Pilar Borque Barrera, Marisol Luján-Sanchis, Begoña Gonzalez Suarez, Vicente Pons Beltrán, Joaquín Sánchez Cuenca, César Prieto de Frías, Fernando Alberca de Las Parras, José Francisco Juanmartiñena Fernández, Enrique Pérez-Cuadrado Robles, Julio Valle Muñoz, Noelia Alonso Lázaro, Blanca Martínez Andrés, Fernando Carballo Álvarez, Cristian Sierra Bernal, Violeta María Sastre Lozano, Carolina Torres González, Cristina Rodríguez de Miguel, Juan Egea-Valenzuela, Ignacio Fernández-Urién Sainz, Cristina Carretero Ribón, Mileidis San Juan Acosta, Félix de Vera Almenar, and Pilar Martínez García
- Subjects
Male ,capsule endoscopy ,Disease ,Capsule Endoscopy ,law.invention ,Feces ,0302 clinical medicine ,Crohn Disease ,law ,small bowel ,Intestine, Small ,Medicine ,030212 general & internal medicine ,Young adult ,Child ,Aged, 80 and over ,education.field_of_study ,Crohn's disease ,Gastroenterology ,Middle Aged ,C-Reactive Protein ,Child, Preschool ,Predictive value of tests ,Biomarker (medicine) ,Female ,030211 gastroenterology & hepatology ,Adult ,medicine.medical_specialty ,Adolescent ,Population ,Risk Assessment ,Sensitivity and Specificity ,Young Adult ,03 medical and health sciences ,Predictive Value of Tests ,Capsule endoscopy ,Internal medicine ,Humans ,education ,Aged ,Hepatology ,business.industry ,biomarkers ,Reproducibility of Results ,medicine.disease ,digestive system diseases ,Calprotectin ,business ,Leukocyte L1 Antigen Complex ,Biomarkers - Abstract
Background Capsule endoscopy (CE) is the first-line investigation in cases of suspected Crohn's disease (CD) of the small bowel, but the factors associated with a higher diagnostic yield remain unclear. Objective Our aim is to develop and validate a scoring index to assess the risk of the patients in this setting on the basis of biomarkers. Patients and methods Data on fecal calprotectin, C-reactive protein, and other biomarkers from a population of 124 patients with suspected CD of the small bowel studied by CE and included in a PhD study were used to build a scoring index. This was first used on this population (internal validation process) and after that on a different set of patients from a multicenter study (external validation process). Results An index was designed in which every biomarker is assigned a score. Three risk groups have been established (low, intermediate, and high). In the internal validation analysis (124 individuals), patients had a 10, 46.5, and 81% probability of showing inflammatory lesions in CE in the low-risk, intermediate-risk, and high-risk groups, respectively. In the external validation analysis, including 410 patients from 12 Spanish hospitals, this probability was 15.8, 49.7, and 80.6% for the low-risk, intermediate-risk, and high-risk groups, respectively. Conclusion Results from the internal validation process show that the scoring index is coherent, and results from the external validation process confirm its reliability. This index can be a useful tool for selecting patients before CE studies in cases of suspected CD of the small bowel.
- Published
- 2018