Danese et al devloped a score for evaluating a patient with suspected Crohn's disease. This can help to avoid diagnostic delay. The authors are from multiple institutions in Europe and the United States.
Patient selection: suspected Crohn's disease
Parameters:
(1) non-healing or complex perianal fistula, abscess or perianal lesion (excluding hemorrhoids)
(2) nocturnal diarrhea
(3) first degree relative with confirmed inflammatory bowel disease
(4) weight loss in the last 3 months
(5) chronic abdominal pain (> 3 months)
(6) mild fever (< 38°C) in the last 3 months
(7) abdominal pain or cramps 30-45 minutes after eating vegetables
(8) rectal urgency
Parameter
Finding
Points
perianal lesion(s)
absent
0
present
5
nocturnal diarrhea
absent
0
present
3
first degree relative
none
0
one or more
4
weight loss
< 5% of usual weight
0
>= 5% of usual weight
3
chronic abdominal pain
absent
0
present
3
mild fever
absent
0
present
2
abdominal pain
absent
2
present
0
rectal urgency
absent
2
present
0
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
• A score >= 8 was associated with Crohn's disease.
Performance:
• The authors state that the area under the ROC curve was 0.97.
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