Mathematical weighting of the pediatric Crohnʼs disease activity index (PCDAI) and comparison with its other short versions

作者：Dan Turner, Anne M. Griffiths, Thomas D. Walters, T J X Seah, James Markowitz, Marian Pfefferkorn, David J. Keljo, Jacob Waxman, Anthony Otley, Neal S. LeLeiko, David Mack, Jeffrey S. Hyams, Arie Levine · 发表于：Inflammatory Bowel Diseases · 年份：2011 · 被引用次数：300 · 研究领域：Inflammatory Bowel Disease、Rheumatoid Arthritis Research and Therapies、Pregnancy and Medication Impact

BACKGROUND: The Pediatric Crohn's Disease Activity Index (PCDAI) has become the standard outcome measure in pediatric Crohn's disease (CD) clinical research. Other versions have been proposed but without systematic evaluation. The aim was to assess validity and responsiveness of the abbreviated PCDAI (abbrPCDAI), short PCDAI (shPCDAI), and modified PCDAI (modPCDAI) as measures of disease activity and to compare these with a mathematically weighted version developed here (wPCDAI). METHODS: The raw data from four prospectively collected datasets were used, totaling 437 children with CD (including two clinical trials). Discriminant validity utilized physician global assessment of disease activity (PGA), and construct validity the correlation with PGA and laboratory results. Feasibility and face validity were ascertained by a survey of 33 experts in pediatric CD. RESULTS: The wPCDAI had better performance than the PCDAI in construct validity and responsiveness and it discriminated better between the disease activity categories (area under the receiver operator characteristic [ROC] 0.97; 95% confidence interval [CI]: 0.95-0.99). In comparison to the original PCDAI, the noninvasive versions (abbrPCDAI and shPCDAI) had lower face, construct, and discriminant validity but were judged to be significantly more feasible. The modPCDAI performed well in the construct validation but was consistently inferior in all other parameters. Cutoffs that correspond to remission, response, and grada...