Clinical indices for pediatric inflammatory bowel disease research

There exists a vast array of measurable parameters in IBD, including various symptoms and signs, as well as endoscopic, serologic, and radiological findings. Hence, the generation of standardized markers which accurately reflect disease state and response to interventions are critical for clinical research. Multiple measuring tools have been developed to cover the various aspects of both Crohn disease and UC including disease activity, patient-reported signs and symptoms, perianal disease, endoscopic and histologic indices, radiographic indices (both for damage and inflammation) as well as disease-specific functional scores including quality of life, disability, fatigue, and work abstinence scores. To be considered clinically accurate, these tools must be evaluated for havening sufficient validity, reliability, responsiveness, and feasibility. Recent directives have placed more emphasis on patient-reported outcomes as an additional measure in clinical trials. This chapter will provide an overview of the main indices used in clinical research, and also clinical practice, with an emphasis on assessing the specific utility of each of these indices.