The agreement among different scoring systems used in the assessment of histologicai activity in ulcerative colitis

Abstract

INTRODUCTION: Histology is one of the most important criteria in determining the disease activity in ulcerative colitis which in turn is important in the choice of drug treatment, monitoring of therapy and in clinical trials. Many different histologicai scoring systems are used to determine the disease activity in ulcerative colitis. OBJECTIVE: To compare three different histologicai scoring systems used in assessing the activity in ulcerative colitis. DESIGN, SETTING AND METHODS: 41 mucosal biopsies of ulcerative colitis patients were reviewed. The histologica! disease activity in each of these was scored by the two authors at a conference microscope using three different histologicai scoring systems. They were A - Bristol activity index, B – scoring index by Saverymutty et al, and C - scoring index by Geboes et al. The correlation among the three histologicai scoring systems was calculated using Spearman rank correlation coefficient. RESULTS: The Spearman rank correlation coefficient between system A vs system B was 0.883 (0.000), system A vs. system C was 0.883 (0.000) and system B vs system C was 0.952 (0.000). The correlation among the three histologicai scoring systems was statistically significant (p<0.01). CONCLUSION: Therefore any one of these three systems can be recommended in scoring the histologicai activity in ulcerative colitis and the choice will depend on the ease of use and personal preference.