• Corinna Lang-Schwarz, Miriam Angeloni, Abbas Agaimy, Raja Atreya, Christoph Becker, Theresa Dregelies, Silvio Danese, Jean-François Fléjou, Nikolaus Gaßler, Heike I Grabsch, Arndt Hartmann, Kateřina Kamarádová, Anja A Kühl, Gregory Y Lauwers, Alessandro Lugli, Iris Nagtegaal, Markus F Neurath, Georg Oberhuber, Laurent Peyrin-Biroulet, Timo Rath, Robert Riddell, Carlos A Rubio, Kieran Sheahan, Britta Siegmund, Herbert Tilg, Vincenzo Villanacci, Maria Westerhoff, Fulvia Ferrazzi, and Michael Vieth.
• Institute of Pathology, Klinikum Bayreuth GmbH, Bayreuth, Germany.
• J Crohns Colitis. 2021 Oct 7; 15 (10): 1621-1630.

Background And AimsHistological scoring plays a key role in the assessment of disease activity in ulcerative colitis [UC] and is also important in Crohn´s disease [CD]. Currently, there is no common scoring available for UC and CD. We aimed to validate the Inflammatory Bowel Disease [IBD]-Distribution [D], Chronicity [C], Activity [A] score [IBD-DCA score] for histological disease activity assessment in IBD.MethodsInter- and intra-rater reliability were assessed by 16 observers on biopsy specimens from 59 patients with UC and 25 patients with CD. Construct validity and responsiveness to treatment were retrospectively evaluated in a second cohort of 30 patients.ResultsInter-rater reliability was moderate to good for the UC cohort (intraclass correlation coefficients [ICCs] = 0.645, 0.623, 0.767 for D, C, and A, respectively) and at best moderate for the CD cohort [ICC = 0.690, 0.303, 0.733 for D, C, and A, respectively]. Intra-rater agreement ranged from good to excellent in both cohorts. Correlation with the Nancy Histological Index [NHI] was moderate and strong with the Simplified Geboes Score [SGS] and a Visual Analogue Scale [VAS], respectively. Large effect sizes were obtained for all three parameters. External responsiveness analysis revealed correlated changes between IBD-DCA score and NHI, SGS and VAS.ConclusionsThe IBD-DCA score is a simple histological activity score for UC and CD, agreed and validated by a large group of IBD specialists. It provides reliable information on treatment response. Therefore, it has potential value for use in routine diagnostics as well as clinical studies.© The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation.

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