Development and validation of a histological index for UC

Mahmoud H. Mosli; Brian G. Feagan; Guangyong Zou; William J. Sandborn; Geert D'Haens; Reena Khanna; Lisa M. Shackelton; Christopher W. Walker; Sigrid Nelson; Margaret K. Vandervoort; Valerie Frisbie; Mark A. Samaan; Vipul Jairath; David K. Driman; Karel Geboes; Mark A. Valasek; Rish K. Pai; Gregory Y. Lauwers; Robert Riddell; Larry W. Stitt; Barrett G. Levesque

doi:10.1136/gutjnl-2015-310393

Development and validation of a histological index for UC

Mahmoud H. Mosli, Brian G. Feagan, Guangyong Zou, William J. Sandborn, Geert D'Haens, Reena Khanna, Lisa M. Shackelton, Christopher W. Walker, Sigrid Nelson, Margaret K. Vandervoort, Valerie Frisbie, Mark A. Samaan, Vipul Jairath, David K. Driman, Karel Geboes, Mark A. Valasek, Rish K. Pai, Gregory Y. Lauwers, Robert Riddell, Larry W. StittBarrett G. Levesque

Laboratory Medicine and Pathology

Research output: Contribution to journal › Article › peer-review

120 Scopus citations

Abstract

OBJECTIVE: Although the Geboes score (GS) and modified Riley score (MRS) are commonly used to evaluate histological disease activity in UC, their operating properties are unknown. Accordingly, we developed an alternative instrument.

DESIGN: Four pathologists scored 48 UC colon biopsies using the GS, MRS and a visual analogue scale global rating. Intra-rater and inter-rater reliability for each index and individual index items were measured using intraclass correlation coefficients (ICCs). Items with high reliability were used to develop the Robarts histopathology index (RHI). The responsiveness/validity of the RHI and multiple histological, endoscopic and clinical outcome measures were evaluated by analyses of change scores, standardised effect size (SES) and Guyatt's responsiveness statistic (GRS) using data from a clinical trial of an effective therapy.

RESULTS: Inter-rater ICCs (95% CIs) for the total GS and MRS scores were 0.79 (0.63 to 0.87) and 0.80 (0.69 to 0.87). The correlation estimates between change scores in RHI and change score in GS and MRS were 0.75 (0.67 to 0.82) and 0.84 (0.79 to 0.88), respectively. The SES and GRS estimates for GS, MRS and RHI were: 1.87 (1.54 to 2.20) and 1.23 (0.97 to 1.50), 1.29 (1.02 to 1.56) and 0.88 (0.65 to 1.12), and 1.05 (0.79 to 1.30) and 0.88 (0.64 to 1.12), respectively.

CONCLUSIONS: The RHI is a new histopathological index with favourable operating properties.

Original language	English (US)
Pages (from-to)	50-58
Number of pages	9
Journal	Gut
Volume	66
Issue number	1
DOIs	https://doi.org/10.1136/gutjnl-2015-310393
State	Published - Jan 1 2017

Keywords

HISTOPATHOLOGY
ULCERATIVE COLITIS

ASJC Scopus subject areas

Gastroenterology

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Mosli, M. H., Feagan, B. G., Zou, G., Sandborn, W. J., D'Haens, G., Khanna, R., Shackelton, L. M., Walker, C. W., Nelson, S., Vandervoort, M. K., Frisbie, V., Samaan, M. A., Jairath, V., Driman, D. K., Geboes, K., Valasek, M. A., Pai, R. K., Lauwers, G. Y., Riddell, R., ... Levesque, B. G. (2017). Development and validation of a histological index for UC. Gut, 66(1), 50-58. https://doi.org/10.1136/gutjnl-2015-310393

Mosli, MH, Feagan, BG, Zou, G, Sandborn, WJ, D'Haens, G, Khanna, R, Shackelton, LM, Walker, CW, Nelson, S, Vandervoort, MK, Frisbie, V, Samaan, MA, Jairath, V, Driman, DK, Geboes, K, Valasek, MA, Pai, RK, Lauwers, GY, Riddell, R, Stitt, LW & Levesque, BG 2017, 'Development and validation of a histological index for UC', Gut, vol. 66, no. 1, pp. 50-58. https://doi.org/10.1136/gutjnl-2015-310393

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title = "Development and validation of a histological index for UC",

abstract = "OBJECTIVE: Although the Geboes score (GS) and modified Riley score (MRS) are commonly used to evaluate histological disease activity in UC, their operating properties are unknown. Accordingly, we developed an alternative instrument.DESIGN: Four pathologists scored 48 UC colon biopsies using the GS, MRS and a visual analogue scale global rating. Intra-rater and inter-rater reliability for each index and individual index items were measured using intraclass correlation coefficients (ICCs). Items with high reliability were used to develop the Robarts histopathology index (RHI). The responsiveness/validity of the RHI and multiple histological, endoscopic and clinical outcome measures were evaluated by analyses of change scores, standardised effect size (SES) and Guyatt's responsiveness statistic (GRS) using data from a clinical trial of an effective therapy.RESULTS: Inter-rater ICCs (95% CIs) for the total GS and MRS scores were 0.79 (0.63 to 0.87) and 0.80 (0.69 to 0.87). The correlation estimates between change scores in RHI and change score in GS and MRS were 0.75 (0.67 to 0.82) and 0.84 (0.79 to 0.88), respectively. The SES and GRS estimates for GS, MRS and RHI were: 1.87 (1.54 to 2.20) and 1.23 (0.97 to 1.50), 1.29 (1.02 to 1.56) and 0.88 (0.65 to 1.12), and 1.05 (0.79 to 1.30) and 0.88 (0.64 to 1.12), respectively.CONCLUSIONS: The RHI is a new histopathological index with favourable operating properties.",

keywords = "HISTOPATHOLOGY, ULCERATIVE COLITIS",

author = "Mosli, {Mahmoud H.} and Feagan, {Brian G.} and Guangyong Zou and Sandborn, {William J.} and Geert D'Haens and Reena Khanna and Shackelton, {Lisa M.} and Walker, {Christopher W.} and Sigrid Nelson and Vandervoort, {Margaret K.} and Valerie Frisbie and Samaan, {Mark A.} and Vipul Jairath and Driman, {David K.} and Karel Geboes and Valasek, {Mark A.} and Pai, {Rish K.} and Lauwers, {Gregory Y.} and Robert Riddell and Stitt, {Larry W.} and Levesque, {Barrett G.}",

note = "Publisher Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.",

year = "2017",

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doi = "10.1136/gutjnl-2015-310393",

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TY - JOUR

T1 - Development and validation of a histological index for UC

AU - Mosli, Mahmoud H.

AU - Feagan, Brian G.

AU - Zou, Guangyong

AU - Sandborn, William J.

AU - D'Haens, Geert

AU - Khanna, Reena

AU - Shackelton, Lisa M.

AU - Walker, Christopher W.

AU - Nelson, Sigrid

AU - Vandervoort, Margaret K.

AU - Frisbie, Valerie

AU - Samaan, Mark A.

AU - Jairath, Vipul

AU - Driman, David K.

AU - Geboes, Karel

AU - Valasek, Mark A.

AU - Pai, Rish K.

AU - Lauwers, Gregory Y.

AU - Riddell, Robert

AU - Stitt, Larry W.

AU - Levesque, Barrett G.

N1 - Publisher Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - OBJECTIVE: Although the Geboes score (GS) and modified Riley score (MRS) are commonly used to evaluate histological disease activity in UC, their operating properties are unknown. Accordingly, we developed an alternative instrument.DESIGN: Four pathologists scored 48 UC colon biopsies using the GS, MRS and a visual analogue scale global rating. Intra-rater and inter-rater reliability for each index and individual index items were measured using intraclass correlation coefficients (ICCs). Items with high reliability were used to develop the Robarts histopathology index (RHI). The responsiveness/validity of the RHI and multiple histological, endoscopic and clinical outcome measures were evaluated by analyses of change scores, standardised effect size (SES) and Guyatt's responsiveness statistic (GRS) using data from a clinical trial of an effective therapy.RESULTS: Inter-rater ICCs (95% CIs) for the total GS and MRS scores were 0.79 (0.63 to 0.87) and 0.80 (0.69 to 0.87). The correlation estimates between change scores in RHI and change score in GS and MRS were 0.75 (0.67 to 0.82) and 0.84 (0.79 to 0.88), respectively. The SES and GRS estimates for GS, MRS and RHI were: 1.87 (1.54 to 2.20) and 1.23 (0.97 to 1.50), 1.29 (1.02 to 1.56) and 0.88 (0.65 to 1.12), and 1.05 (0.79 to 1.30) and 0.88 (0.64 to 1.12), respectively.CONCLUSIONS: The RHI is a new histopathological index with favourable operating properties.

AB - OBJECTIVE: Although the Geboes score (GS) and modified Riley score (MRS) are commonly used to evaluate histological disease activity in UC, their operating properties are unknown. Accordingly, we developed an alternative instrument.DESIGN: Four pathologists scored 48 UC colon biopsies using the GS, MRS and a visual analogue scale global rating. Intra-rater and inter-rater reliability for each index and individual index items were measured using intraclass correlation coefficients (ICCs). Items with high reliability were used to develop the Robarts histopathology index (RHI). The responsiveness/validity of the RHI and multiple histological, endoscopic and clinical outcome measures were evaluated by analyses of change scores, standardised effect size (SES) and Guyatt's responsiveness statistic (GRS) using data from a clinical trial of an effective therapy.RESULTS: Inter-rater ICCs (95% CIs) for the total GS and MRS scores were 0.79 (0.63 to 0.87) and 0.80 (0.69 to 0.87). The correlation estimates between change scores in RHI and change score in GS and MRS were 0.75 (0.67 to 0.82) and 0.84 (0.79 to 0.88), respectively. The SES and GRS estimates for GS, MRS and RHI were: 1.87 (1.54 to 2.20) and 1.23 (0.97 to 1.50), 1.29 (1.02 to 1.56) and 0.88 (0.65 to 1.12), and 1.05 (0.79 to 1.30) and 0.88 (0.64 to 1.12), respectively.CONCLUSIONS: The RHI is a new histopathological index with favourable operating properties.

KW - HISTOPATHOLOGY

KW - ULCERATIVE COLITIS

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DO - 10.1136/gutjnl-2015-310393

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Development and validation of a histological index for UC

Abstract

Keywords

ASJC Scopus subject areas

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