Crohn's Disease Clinical Trial
Official title:
Capsule Endoscopy Crohn's Disease Activity Index - Validation Multi Center Study
The Study
1. Prospective trial of the Niv score validating score against known activity indices -
see addendum A for Niv score
2. Known Crohn's disease patients undergoing capsule endoscopy are identified - see
addendum B for inclusion/exclusion criteria
3. Prior to capsule exam, temperature is taken, height and weight measured, bloods are
drawn for albumin, ESR, HCT, CRP
4. Prior to capsule exam, symptom/exam questionnaire is completed - see addendum C for
questionnaire
5. Capsule exam is performed
6. CD of de-identified is made at the study site.
7. Landmarks are confirmed and the small bowel transit time is divided into 2 and labeled
on thumbnails
8. CDs are copied
9. CDs of study patients are provided to blinded readers
The Niv score was devised to measure mucosal disease activity in Crohn's disease using
capsule endoscopy. This scoring index is based on inflammatory score parameters: Erythema,
hyperemia, edema, denudation, nodularity, apthae, erosion, ulcer, bleeding), extent score:
Focal, patchy, diffuse, and stricture score: single-passed, multiple-passed, obstruction.
The higher the score, the more involvement is observed. The advantage of this index is that
it actually measures disease activity and not symptoms in an easy non-invasive manner. For
assessing Crohn's disease, mucosal healing can be directly seen and if there is no mucosal
disease there can be no symptoms secondary to inflammatory bowel disease. The subjective
nature of disease activity indices is avoided, as is the problem of disease without
symptoms. It is envisioned that the Niv score could diagnose Crohn's disease (excluding
normally occurring mucosal breaks), identify NSAID damage, measure disease activity /
severity, measure drug response for clinical trials and in practice, and guide medical
management for the patient's with small bowel Crohn's disease.
This study will measure the Niv score against CDAI. Since capsule endoscopy assesses mucosal
disease and not symptoms it is not envisioned that the Niv score will perfectly correlate
with the Harvey-Bradshaw score. It is envisioned that the Niv score will have the same
direction. Both of these indices will be determined as part of a multicenter trial. The
trial design is outlined below.
The Study
1. Prospective trial of the Niv score validating score against known activity indices -
see addendum A for Niv score
2. Known Crohn's disease patients undergoing capsule endoscopy are identified - see
addendum B for inclusion/exclusion criteria
3. Prior to capsule exam, temperature is taken, height and weight measured, bloods are
drawn for albumin, ESR, HCT, CRP
4. Prior to capsule exam, symptom/exam questionnaire is completed - see addendum C for
questionnaire
5. Capsule exam is performed
6. CD of de-identified is made at the study site.
7. Landmarks are confirmed and the small bowel transit time is divided into 2 and labeled
on thumbnails
8. CDs are copied
9. CDs of study patients are provided to blinded readers
Scoring sheets will be provided to readers - see addendum A
10. Readers will score the CDs and return the scoring sheets to the principal investigator
11. Data is collated and analyzed
;
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Diagnostic
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