Publicaciones científicas

Development and validation of a scoring index to predict the presence of lesions in capsule endoscopy in patients with suspected Crohn's disease of the small bowel: a Spanish multicenter study

01-may-2018 | Revista: European Journal of Gastroenterology & Hepatology

Egea-Valenzuela J (1), González Suárez B (2), Sierra Bernal C (3), Juanmartiñena Fernández JF (4), Luján-Sanchís M (5), San Juan Acosta M (6), Martínez Andrés B (7), Pons Beltrán V (8), Sastre Lozano V (9), Carretero Ribón C (10), de Vera Almenar F (11), Sánchez Cuenca J (12), Alberca de Las Parras F (1), Rodríguez de Miguel C (2), Valle Muñoz J (3), Férnandez-Urién Sainz I (4), Torres González C (5), Borque Barrera P (6), Pérez-Cuadrado Robles E (7), Alonso Lázaro N (8), Martínez García P (9), Prieto de Frías C (10), Carballo Álvarez F (1).


Capsule endoscopy (CE) is the first-line investigation in cases of suspected Crohn's disease (CD) of the small bowel, but the factors associated with a higher diagnostic yield remain unclear.


Our aim is to develop and validate a scoring index to assess the risk of the patients in this setting on the basis of biomarkers.


Data on fecal calprotectin, C-reactive protein, and other biomarkers from a population of 124 patients with suspected CD of the small bowel studied by CE and included in a PhD study were used to build a scoring index. This was first used on this population (internal validation process) and after that on a different set of patients from a multicenter study (external validation process).


An index was designed in which every biomarker is assigned a score. Three risk groups have been established (low, intermediate, and high). In the internal validation analysis (124 individuals), patients had a 10, 46.5, and 81% probability of showing inflammatory lesions in CE in the low-risk, intermediate-risk, and high-risk groups, respectively. In the external validation analysis, including 410 patients from 12 Spanish hospitals, this probability was 15.8, 49.7, and 80.6% for the low-risk, intermediate-risk, and high-risk groups, respectively.


Results from the internal validation process show that the scoring index is coherent, and results from the external validation process confirm its reliability. This index can be a useful tool for selecting patients before CE studies in cases of suspected CD of the small bowel.

CITA DEL ARTÍCULO  Eur J Gastroenterol Hepatol. 2018 May;30(5):499-505. doi: 10.1097/MEG.0000000000001083