Patient selection: ulcerative colitis
Outcome: overall disease activity
Parameters:
(1) mucosal lesions (confirmed by endoscopy)
(2) recent disease-related hospitalizations in past 12 months
(3) nocturnal bowel movements
(4) rectal bleeding
(5) disease extent
(6) frequency of loose stools per week
(7) CRP level in mg/L
(8) use of biologics
(9) impact on daily activities
(10) serum albumin level in g/dL
(11) anorectal symptoms (anorectal pain, bowel urgency, incontinence, discharge, tenesmus)
(12) anemia (by WHO criteria for age and gender)
(13) steroid use in past year
|
Parameter
|
Finding
|
Points
|
|
mucosal lesions
|
none
|
0
|
|
|
active erosions
|
14
|
|
|
active ulcers
|
18
|
|
recent hospitalization
|
absent
|
0
|
|
|
present
|
8
|
|
nocturnal bowel movements
|
absemt
|
0
|
|
|
present
|
4
|
|
rectal bleeding
|
none
|
0
|
|
|
present
|
3
|
|
disease extent
|
distal colitis (can be treated with enemas)
|
0
|
|
|
extensive
|
5
|
|
frequency of loose stools
|
not increased
|
0
|
|
|
increased one per day compared to baseline
|
4
|
|
|
increased by 2 or more
|
5
|
|
CRP level
|
normal (<= 3 mg/L)
|
0
|
|
|
3.01 to 5 mg/L
|
4
|
|
|
> 5 mg/L
|
11
|
|
use of biologics
|
never used
|
0
|
|
|
some improvement with
|
4
|
|
|
no improvement with
|
10
|
|
daily activity impact
|
none
|
0
|
|
|
significantly impacts
|
14
|
|
serum albumin
|
>= 3.5 g/dL
|
0
|
|
|
< 3.5 g/dL
|
5
|
|
anorectal symptoms
|
no symptoms
|
0
|
|
|
any symptoms
|
4
|
|
anemia
|
absent
|
0
|
|
|
present
|
5
|
|
steroid use
|
none in past year
|
0
|
|
|
any in past year
|
8
|
total score =
= SUM(points for all 13 parameters)
Interpretation:
• minimum score: 0
• maximum score: 100
• The higher the score the more active the ulcerative colitis.
