The patient simple clinical colitis activity index (P-SCCAI) can detect ulcerative colitis (UC) disease activity in remission: a comparison of the P-SCCAI with clinician-based SCCAI and biological markers

J Crohns Colitis. 2013 Dec;7(11):890-900. doi: 10.1016/j.crohns.2012.11.007. Epub 2012 Dec 24.


Aim: To develop a patient-based Simple Clinical Colitis Activity Index (P-SCCAI) of ulcerative colitis (UC) activity and to compare it with the clinician-based SCCAI, C-reactive protein (CRP) and Physician's Global Assessment (PGA) of UC activity. Monitoring UC activity may give patients disease control and prevent unnecessary examinations.

Methods: Consecutive UC patients randomly completed the P-SCCAI either before or after consultation. Gastroenterologists assessed patients' UC activity on the same day. Overall agreement between SCCAI and P-SCCAI was calculated with Spearman's Rho and Mann-Whitney U test. Agreement regarding active disease versus remission and agreement at domain level were calculated by percent agreement and kappa (κ).

Results: 149 (response rate 84.7%) UC patients participated. P-SCCAI and SCCAI showed a large correlation (rs=0.79). The medians (IQR) of the P-SCCAI (3.78;0-15) tended to be higher than those of the SCCAI (2.86;0-13), although this difference did not reach statistical significance (z=1.71| p=0.088). In 77% of the cases the difference between clinicians' and patients' scores was not clinically different (i.e.≤2). Percentage agreement between clinicians and patients, judging UC as active or in remission, was 87%, rs=0.66, κ=0.66, indicating a substantial agreement. In general patients tended to report more physical symptoms than clinicians. C-Reactive protein (CRP) was found to have a significant association with both P-SCCAI and SCCAI (κ=0.32, κ=0.39 respectively) as was PGA (κ=0.73 for both indices).

Conclusions: The P-SCCAI is a promising tool given its substantial agreement with the SCCAI and its feasibility. Therefore, P-SCCAI can complement SCCAI in clinical care and research.

Keywords: Disease activity;; Inflammatory bowel disease;; Simple Clinical Colitis Activity Index; Ulcerative colitis;; Validation;.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Adult
  • Biomarkers / blood
  • Cohort Studies
  • Colitis, Ulcerative / diagnosis*
  • Diagnostic Self Evaluation
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Physician-Patient Relations
  • Practice Patterns, Physicians' / standards*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Sickness Impact Profile
  • Statistics, Nonparametric
  • Surveys and Questionnaires


  • Biomarkers