The National Cooperative Crohn's Disease Study Group developed an activity index to monitor patient's with Crohn's disease. From an initial group of 18 variables, 8 were selected to be included in the index.
|
Parameter |
raw coefficient |
standardized coefficient |
rounded coefficient |
|
stools |
0.0246 |
1.95 |
3 |
|
pain |
0.0648 |
5.14 |
5 |
|
well-being |
0.0907 |
7.29 |
7 |
|
symptoms |
0.2809 |
22.27 |
20 |
|
lomotil |
0.4516 |
35.80 |
30 |
|
abdominal mass |
0.6568 |
52.08 |
50 |
|
hematocrit |
0.0798 |
6.33 |
6 |
|
body weight |
0.0126 |
1.00 |
1 |
Table 3, page 442
Patient Instructions: For the 7 days prior to the next clinic visit, record the following each day prior to going to bed:
(1) the number of liquid or very soft stools per day
(2) the level of abdominal pain (none, mild, moderate, severe)
(3) the general well-being felt that day (generally well, slightly under par, poor, very poor, terrible)
|
Parameter |
Finding |
Points |
|
number of liquid or very soft stools |
total number of daily stools for 7 days |
(total number) * 2 |
|
abdominal pain
|
sum of daily abdominal pain scores • none = 0 • mild = 1 • moderate = 2 • severe =3 |
(sum daily scores) * 5 |
|
general well-being
|
sum of daily well-being scores • well = 0 • under par = 1 • poor = 2 • very poor =3 • terrible = 4 |
(sum daily scores) * 7 |
|
number of symptoms (6) present |
• arthritis, arthralgias • iritis, uveitis • erythema nodosum, pyoderma gangrenosum, aphthous stomatitis • anal fissure, fistula or abscess • other fistula • fever > 100 °F during past week |
(number present) * 20 |
|
taking Lomotil for diarrhea |
yes |
30 |
|
|
no |
0 |
|
abdominal mass |
• none = 0 • questionable = 2 • definite = 5 |
(points for abdominal mass) * 10 |
|
hematocrit |
male: 47 - hematocrit |
(difference) * 6 |
|
|
female: 42 - hematocrit |
(difference) * 6 |
|
body weight |
100 * (1 - ((current weight) / (standard weight))) |
(value) * 1 |
where:
• the definition for each parameter given in Table 2, page 441
activity index =
= SUM(points for each parameter)
Interpretation:
• minimum score: about -25
• maximum score: about 625
• An increase in the index between visits (negative difference for last index less the current index) correlates with worsening of the patient's condition, while a decrease (positive difference for last index less the current index) was associated with improvement.
|
Clinical Status (Physician's Rating) |
Mean Score for Patient with Rating |
|
very well |
90 |
|
fair to good |
195 |
|
poor |
310 |
|
very poor |
510 |
Figure 1, page 442.
In the implementation, I somewhat arbitrarily used the following for rating
|
Score |
Rating |
|
> 425 |
very poor |
|
291 to 425 |
poor |
|
151 to 290 |
fair to good |
|
<= 150 |
very well |
Purpose: To monitor the clinical status of a patient with Crohn's disease using the Crohn's Disease Activity Index (CDAI).
Specialty: Gastroenterology
Objective: severity, prognosis, stage
ICD-10: K50,
