TOPLINE

Simplified patient-reported outcome (PRO) scores, PRO2 and PRO3, could be calculated in more than 80% of real-world clinic visits for Crohn's disease (CD), compared with roughly 1 in 4 visits for the Crohn's Disease Activity Index (CDAI) and Harvey-Bradshaw Index (HBI). The PRO-based scores showed strong agreement with these established indices in categorizing disease severity, suggesting they may offer a more feasible option for monitoring CD activity in routine and telehealth care.

METHODOLOGY

• The CDAI and HBI require laboratory values and physical examination findings that are not consistently captured at the point of care, prompting researchers to determine whether simplified, patient-reported measures could serve as a practical substitute.
• They analyzed 26,230 clinical assessments of patients with CD, recorded since 2018 in an electronic medical record system spanning Australia and New Zealand, and compared four disease activity scores — CDAI, HBI, PRO2, and PRO3.
• At each visit, patients reported three outcomes — liquid stools over the past 24 hours, average abdominal pain over the past 7 days, and average general well-being over the past 7 days — which were used to calculate PRO2 and PRO3. CDAI and HBI were also calculated when entered, but they required additional clinical and laboratory data beyond these inputs.
• All four scores categorized disease activity as remission, mild, moderate, and severe. 
• The team then checked how often each pair of scores placed a given patient in the same disease activity category at the same visit.

TAKEAWAY

• CDAI could be calculated in just 6509 of 26,230 visits (24.8%), and HBI in 7043 (26.9%). PRO2, by contrast, was available in 21,416 visits (81.6%), and PRO3 in 21,234 (81.0%). 
• PRO2 showed 87.6% agreement with CDAI in categorizing disease severity, and 93.3% agreement with HBI in categorizing disease severity. PRO3 showed 86.8% agreement with CDAI and 88.2% agreement with HBI.
• Even in the cases where PRO2 or PRO3 didn't match CDAI or HBI, the mismatch was almost always minor — 92.1% to 98.5% of disagreements were off by just one severity level.
• Statistically, PRO2 and PRO3 tracked closely with both CDAI and HBI, reinforcing that the simpler, patient-driven scores capture much of the same information as the more data-intensive indices.

IN PRACTICE

"PRO2 and PRO3 are valid, reliable, and clinical feasible alternative to the CDAI and HBI. Its simplicity and objective structure enable consistent application across telehealth and digital health platforms, supporting its scalability for routine clinical practice," the authors wrote.

SOURCE

The study was led by Wai Kin Su, Liverpool Hospital, Liverpool, Australia. It was published online in Gastro Hep Advances.

LIMITATIONS

Limitations were not explicitly stated.

DISCLOSURES

No funding was reported for the study. Two authors disclosed receiving speaker fees, educational support, honoraria for advisory board participation, and/or research support from multiple companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.