Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Patient knows best when it comes to ulcerative colitis

28.02.2005


Patient-reported symptoms can be used as an effective alternative to endoscopy to monitor progression of ulcerative colitis
People living with fatigue, abdominal discomfort and bloody diarrhea caused by the chronic inflammation of ulcerative colitis may no longer need to undergo frequent and uncomfortable endoscopies, a new study shows. Researchers at the University of Michigan Health System found that disease severity in patients with ulcerative colitis can be evaluated accurately in clinical practice and research trials without frequent lower endoscopies. The results from the study are published in the February 2005 issue of the American Journal of Gastroenterology.

This new finding will spare patients the discomfort of undergoing regular endoscopies to monitor disease activity, and save researchers the expense of using endoscopy as part of clinical trials, says lead author Peter D.R. Higgins, M.D., Ph.D., lecturer in the Division of Gastroenterology and Hepatology in the Department of Internal Medicine at the University of Michigan Medical School. "Currently, common disease activity indices require an endoscopy every time a patient with ulcerative colitis is evaluated to measure disease activity and monitor the effectiveness of new therapies," says Higgins. "However, this study suggests that endoscopy does not provide physicians with enough new information about the activity of the patient’s disease to make it necessary for patients to have to undergo the discomfort of an endoscopy."


Several disease activity measurement scales have been developed – some requiring endoscopy and some not – to monitor the activity of ulcerative colitis, an inflammatory bowel disease that affects more than one million Americans and causes inflammation and bleeding of the colon and rectum. Since none of the scales have been rigorously tested, experts in the field, especially those in clinical research, tend to use multiple disease activity indices, including those requiring endoscopy, to assess patients.

With no gold standard in place to measure disease activity, Higgins and his colleagues set out to determine if endoscopy is truly needed to accurately measure disease activity in ulcerative colitis. For the comparative study, 66 ulcerative colitis patients with scheduled lower endoscopy appointments at the U-M Health System’s Medical Procedures Unit were evaluated using two indices requiring endoscopy and two non-endoscopic measures of disease activity.

The patient sample, gathered over a five-month period, included both very ill inpatients and healthy outpatients with less active disease, a range that is representative of patients participating in clinical trials. Prior to their scheduled endoscopy, patients completed a 50-question survey and provided a blood sample to collect data to compare the invasive indices (the St. Marks’s Index and the Ulcerative Colitis Disease Activity Index) and the noninvasive indices (the Simple Clinical Colitis Activity Index and the Seo Index).

As part of the St. Mark’s and the UCDAI measures, patients undergo a physician assessment and endoscopy, while the SCCAI and the Seo index use a six-question symptom survey and a two-question survey with blood tests, respectively, to measure ulcerative colitis.

To learn how much information endoscopies contribute to the measurement of disease activity, each endoscopic index was analyzed to determine how well it predicted disease activity with and without the endoscopic item. The prediction of disease activity was nearly as good (only 3 percent less accurate) without the endoscopic information. The St. Mark’s Index and the UCDAI endoscopy items correlated with patient-reported stool frequency and stool blood, which are already measured in the indices through survey questions.

These findings suggest endoscopy is not a necessary component to determine disease activity and that less expensive, noninvasive indices may be reasonable alternatives for measuring disease activity for ulcerative colitis, says Higgins. "Our data support a common clinical practice of following the self-reported symptoms of patients with ulcerative colitis, rather than assessing patients with endoscopy each time symptoms flare," says Higgins. "

Adds co-author Ellen Zimmermann, M.D., associate professor of Internal Medicine at UMHS: "While endoscopy is still necessary to diagnose ulcerative colitis and to evaluate a patient for early signs of cancer, patients may be more willing to participate in clinical trials of new treatments if there are not so many colonoscopies involved."

Although the study favors the use of noninvasive indices to measure ulcerative colitis activity, Higgins feels that the SCCAI and Seo index could still be improved by including additional non-endoscopic components to further enhance the measurement of ulcerative colitis activity in patients.

Krista Hopson | EurekAlert!
Further information:
http://www.umich.edu

More articles from Health and Medicine:

nachricht Organ-on-a-chip mimics heart's biomechanical properties
23.02.2017 | Vanderbilt University

nachricht Researchers identify cause of hereditary skeletal muscle disorder
22.02.2017 | Klinikum der Universität München

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Stingless bees have their nests protected by soldiers

24.02.2017 | Life Sciences

New risk factors for anxiety disorders

24.02.2017 | Life Sciences

MWC 2017: 5G Capital Berlin

24.02.2017 | Trade Fair News

VideoLinks
B2B-VideoLinks
More VideoLinks >>>