Are endoscopic grading and scoring systems in inflammatory bowel disease the same?

OBJECTIVE: To assess the correlation and difference between various endoscopic grades and indices for assessment of endoscopic disease activity in inflammatory bowel disease (IBD).

METHODS: Eighty consecutive patients with ulcerative colitis (UC), and 31 patients with Crohn's disease (CD) were evaluated based on multiple endoscopic criteria between June 2006 and February 2007 at the Department of Gastroenterology of Renji Hospital, Shanghai, China. Two experienced endoscopists evaluated the endoscopic findings using various systems independently. Data were analyzed using Kendall's coefficient of concordance and Spearman correlations.

RESULTS: For the systems of UC and CD, Kendall's coefficients of concordance were 0.714 (p<0.001) and 0.342 (p<0.001). There was no significant difference between the 2 systems of UC (all p<0.01). However, no statistically significant concordances were found between Chinese Grading System of Crohn's Disease (CGSCD) and Crohn's Disease Endoscopic Index of Severity (CDEIS) (rs=0.323, p=0.076). Significant differences in frequencies were detected among endoscopic systems for UC (p=0.001).

CONCLUSION: It was suggested in our study that endoscopic grading and scoring systems of UC had satisfactory concordance, and CGSCD showed room for improvement. However, the modified Baron scale was tend to severe category, while Jeroen classification was tend to mild category.