COSMIN database

Histologic evaluation of ulcerative colitis: a systematic review of disease activity indices

Mosli, M. H., Feagan, B. G., Sandborn, W. J., D'Haens, G., Behling, C., Kaplan, K., Driman, D. K., Shackelton, L. M., Baker, K. A., Macdonald, J. K., Vandervoort, M. K., Geboes, K., and Levesque, B. G.
BACKGROUND: Ulcerative colitis (UC) is an idiopathic inflammatory disorder. Currently, the main goals of treatment are to induce and maintain clinical and/or endoscopic remission. However, evidence indicates that persistent disease activity on colonic biopsies in the setting of clinical or endoscopic remission is an independent predictor of poor outcomes. A number of previous studies have proposed histologic indices for use in specific trials of UC. The aim of this study was to systematically review the existing histological indices for UC and assess their potential use in both patient management and clinical trials.

METHODS: We performed a systematic review of histological indices evaluating disease activity in UC. MEDLINE (Ovid), EMBASE (Ovid), PubMed, the Cochrane Library (CENTRAL), and Digestive Diseases Week (DDW) abstracts of randomized and/or controlled trials clinical trials were searched from inception to February 2013 for applicable studies. Data from these studies were reviewed and analyzed.

RESULTS: After systematically applying inclusion criteria, we identified 108 scientific articles including 88 clinical studies and 21 related clinical reviews. Eighteen indices of histological activity in UC were identified and reviewed.

CONCLUSIONS: Although multiple histological scoring indices for assessment of UC disease activity currently exist, none of these instruments were developed using a formal validation process and their operating properties remain poorly understood. Future studies are needed to address this deficiency.
Inflamm Bowel Dis
1536-4844 (Electronic)
Publication year:
Biological and physiological variables:
Biological and physiological variables
Adults (18-65)
Children (0-18)
Seniors (65+)
Diseases of and symptoms related to the digestive system
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
6 - Clinical rating scales
9 - Laboratory tests
Chicago score
Floren Index
Friedman Index
Geboes Score
Gomes Score
Hanauer Index
Harpaz Index
Initial Riley Score
Keren Score
Matts Score
Modified Riley score
Odze Index
Riley Score
Sandborn Index
Saverymuttu Index
Scheppach/D’Argenio Score
Truelove and Richards index
Watts Score