Is an Abbreviated Pediatric Crohn’s Disease Activity Index Better Than the Original?

OBJECTIVE: The Pediatric Crohn's Disease Activity Index (PCDAI) is a validated measure of disease activity comprised of historical, laboratory and physical examination parameters. It has been suggested that an abbreviated PCDAI may be of similar utility without requiring laboratory evaluations or calculated height velocity. The aim of this study was to compare an abbreviated PCDAI and the original PCDAI and also compare the abbreviated PCDAI and a quality-of-life measurement. METHODS: The authors prospectively analyzed quality of life and disease activity, using the IMPACT-35 Questionnaire, the PCDAI and an abbreviated PCDAI consisting of three historical items (abdominal pain, stools and patient functioning) and three physical examination items (weight, abdomen and perirectal disease). RESULTS: Forty subjects aged 5-24 years (22 males) were included in analysis. Correlations were performed between the original PCDAI, an abbreviated PCDAI and the IMPACT-35. There was a significant, strong correlation between the PCDAI and the abbreviated PCDAI (n = 40, r = 0.849, p <0.001), a significant, moderate correlation between PCDAI and IMPACT-35 (n = 29, r = -0.547, p = 0.002) and a significant, moderate correlation between the abbreviated PCDAI and IMPACT-35 (n = 29, r = -0.579, p <0.001). CONCLUSIONS: An abbreviated PCDAI predicted disease activity as well as the full PCDAI. The IMPACT-35 correlated well with disease activity based on both PCDAI and an abbreviated PCDAI. An abbreviated PCDAI may offer advantages over the original PCDAI and should be prospectively validated in future studies.