Buchner Anna M, Lichtenstein Gary R
Division of Gastroenterology at University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Am J Gastroenterol. 2017 Oct;112(10):1593-1595. doi: 10.1038/ajg.2017.229.
There are currently two validated endoscopic indices for evaluation of Crohn's disease (CD), the Crohn's disease Endoscopic Index of Severity (CDEIS) and the Simple Endoscopic Score for Crohn's disease (SES-CD). The study by Khanna et al. evaluated the responsiveness of the SES-CD and CDEIS using data from a trial of adalimumab. The study used appropriate statistical methods to quantify responsiveness of the indices as assessed by blinded central readers. The SES-CD demonstrated numerically greater responsiveness to a treatment of known efficacy, suggestive that the SES-CD is more efficient outcome measure than the CDEIS. Removal of stenosis as an index item and adjusting for observed segments did not improve responsiveness. In the future, the implementation of the SES-CD into daily clinical practice may become a practical tool used by gastroenterologists when caring for patients with Crohn's disease. Further studies analyzing the responsiveness of the indices in combination with clinical and patients' driven outcomes are expected prior to the indices' use in "prime time".
目前有两种经过验证的用于评估克罗恩病（CD）的内镜指数，即克罗恩病内镜严重程度指数（CDEIS）和克罗恩病简易内镜评分（SES-CD）。Khanna等人的研究利用阿达木单抗试验的数据评估了SES-CD和CDEIS的反应性。该研究使用了适当的统计方法来量化由盲法中央阅片者评估的指数反应性。SES-CD在数值上对已知疗效的治疗表现出更大的反应性，这表明SES-CD作为结局指标比CDEIS更有效。去除狭窄作为一个指数项目并对观察到的节段进行调整并没有提高反应性。未来，将SES-CD应用于日常临床实践可能会成为胃肠病学家在护理克罗恩病患者时使用的一种实用工具。在这些指数用于“黄金时段”之前，预计还会有进一步的研究来分析这些指数与临床和患者驱动的结局相结合的反应性。
