COSMIN database

Crohn's disease: systematic review of assessment of disease severity and its relevance to surgery

Rao, P. K., Davies, M., Price, P. E., and Torkington, J.
BACKGROUND: The aims of treatments for Crohn's disease are symptom control by medical or surgical means and improvement in health-related quality of life (HRQOL). A wide number of classification systems, instruments of disease activity measurement (DAM) and HRQOL are available, but few are used in routine surgical practice.

OBJECTIVE: To review the validity of DAM and HRQOL instruments and their applicability to surgically treated patients.

METHOD: A systematic literature search was undertaken to identify these instruments. Qualifying articles were used to determine the construct, content and criterion validity of the instruments identified with respect to surgically treated patients.

RESULTS: Thirteen disease activity indices and 11 HRQOL assessment tools were identified. Construct validity was demonstrated throughout but concerns of content and criterion validity were noted.

CONCLUSION: None of the current disease activity or HRQOL tools can be used without potential bias in a trial of surgical vs medical therapy as the items included favour the outcomes experienced following medical therapy. A more balanced assessment tool in the setting of a multidisciplinary trial is needed.
Colorectal Dis
1462-8910 (Print)
Publication year:
Biological and physiological variables:
Biological and physiological variables
Symptom status:
Physical state
General health perceptions / HRQoL:
Health-related quality of life
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the digestive system
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
6 - Clinical rating scales
8 - Imaging tests
9 - Laboratory tests
3CDAI - Triple parametric Crohn’s Disease Activity Index
Cape Town Index (OR: South African Index)
CDAI - Crohn’s Disease Activity Index
CDEIS - Crohn’s Disease Endoscopic Index of Severity
CGQL - Cleveland Global Quality of Life Questionnaire (OR: CGQOL)
DUPH - Duke-Unc Health Profile
EQ-5D - EuroQoL-5 Dimensions   
European Index
HBI - Harvey-Bradshaw Index (OR: Simple Index) (versions: pHBI - patient HBI; HBImApp - HBI mobile App)
IBDQ - Inflammatory Bowel Disease Questionnaire (versions: IBDQ-32; IBDQ-5Likert; IBDQ-30; sIBDQ-10; IBDQ-36; sIBDQ-9; EIBDQ - Edinburgh IBDQ)
IBDQOL - Inflammatory Bowel Disease Quality of Life Questionnaire
IOIBD - International Organization for study of Inflammatory Bowel Disease Index (OR: Oxford Index)
Korelitz Scoring
OMGE - Organisation Mondiale de Gastroenterologie Index
RFIPC - Rating Form of IBD patient Concerns
Rutgeerts’ Score
Scoring System for Histologic Abnormalities in Crohn’s Disease Mucosal Biopsy Specimen
SES-CD - Simple Endoscopic Score for Crohn’s Disease
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: Medical Outcomes Study (MOS) SF-36]]    |  | also see:
SIP - Sickness Impact Profile   
VHI - Van Hees Index (OR: Dutch Index)