Turner et al reported the Pediatric Ulcerative Colitis Activity Index (PUCAI) for evaluating a pediatric patient with ulcerative colitis. Changes in the PUCAI indicates changes in the patient's disease activity. The authors are from multiple institutions in Canada and the United States.
Patient selection: pediatric patient with ulcerative colitis
Parameters:
(1) baseline PUCAI
(2) current PUCAI
delta PUCAI =
= (baseline PUCAI) - (current PUCAI)
Figure 2B, Turner (2007)
delta PUCAI
Status
>= 35
significant improvement
20 to 34
moderate improvement
10 to 19
small improvement
0 to 9
no improvement
Figure 2, Turner (2009)
delta PUCAI
Change in Physician Global Assessment
>= 30
moderate to large improvement
11 to 29
small improvement
-10 to 10
no change
-11 to -18
mild to moderate worsening
< -18
moderate to marked worsening
Table 3, Dotson et al
Mean delta PUCAI
Status
35 (-10 to 75)
improved
0 (-5 to 5)
stable
-40 (-80 to 0)
worsened
Figure 2, Dotson et al
Change in Physician Global Assessment
Mean Delta PUCAI
large improvement
45
moderate improvement
30
mild improvement
12
no change
0
small worsening
-15
moderate worsening
-38
large worsening
-60
A delta PUCAI of 12 or greater is considered real and not due to interrater variability (Turner 2009). This suggests that -11 to 11 should be used to define stable disease.
For the implementation the following will be used:
delta PUCAI
Status
>= 30
significant improvement
12 to 29
small improvement
-11 to 11
no change
-12 to -24
mild worsening
< -24
significant worsening
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