***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : We aim ed to determine the optimal approach to assess disease activity ( i.e. , biological inflammation ) in ulcerative colitis ( UC ) by comparing patients ' and physicians ' rating of the disease . Methods : This was a prospect i ve , multicenter , double‐cohort study . The first cohort was composed of 94 children with UC ( parent proxy when required ) and their physicians who provided independent clinical report and global assessment of disease , rated on a 100 mm visual analog scale . Constructs of disease activity ( including mucosal inflammation , laboratory tests , Mayo score , and the Pediatric UC Activity Index ) , were scored by an independent blinded physician and used to compare validity of the assessment . Of the 94 children , 43 were seen at a follow‐up visit and provided a global rating of change in disease activity . To ascertain whether age influences assessment accuracy , a second cohort of 86 adult UC patients were analyzed in a similar way . Results : In both cohorts the physician global assessment had higher correlations with all constructs of disease activity than did the patient ' global assessment ( for colonoscopic score r = 0.76 vs. r = 0.29 , P = 0.002 ) . Even with abdominal pain , a subjective item , the physician 's rating had higher correlation than the patient 's rating . Similarly , the physician rating of change better reflected change in disease activity than that of the patient rating . Conclusions : For indirect measurement of biological activity on the basis of symptoms and signs , clinician assessment s are superior to those of patients . Patient assessment s , physician assessment s , and direct measurement of disease activity provide complementary information in clinical research . ( Inflamm Bowel Dis 2009 Background : The Mayo score and a noninvasive 9‐point partial Mayo score are used as outcome measures for clinical trials assessing therapy for ulcerative colitis ( UC ) . There are limited data assessing what defines a clinical ly relevant change in these indices . We sought to assess what constitutes a clinical ly meaningful change in these indices using data from a recently completed placebo‐controlled clinical trial . Methods : In all , 105 patients were enrolled in a 12‐week r and omized , placebo‐controlled trial assessing rosiglitazone for treatment of mild to moderate UC . We compared the change in  the Mayo score , the partial Mayo score , and a 6‐point score composed just of the stool frequency and bleeding components of the Mayo score to the patient 's perception of disease activity at week 0 and week 12 . Optimal cutpoints were calculated as the maximal product of sensitivity and specificity . Results : Each index was strongly correlated with the patient 's rating of disease activity at week 12 ( Spearman correlations 0.61–0.71 , P < 0.0001 for all correlations ) . The maximal product of sensitivity and specificity to identify patient reported improvement of disease activity was achieved using cutpoints for change of 2.5 for the Mayo score ( sensitivity 88 % , specificity 80 % ) , 2.5 for the partial Mayo score ( sensitivity 88 % , specificity 87 % ) , and 1.5 for the 6‐point score ( sensitivity 88 % , specificity 80 % ) . Conclusions : The partial Mayo score and the 6‐point score composed solely of the stool frequency and bleeding components performed as well as the full Mayo score to identify patient perceived clinical response Background : Various physician- and patient-reported instruments exist for quantification of disease activity in inflammatory bowel diseases ( IBD ) but none are widely used in routine clinical practice . A simple patient-reported outcome measure might help inform clinical decision making . We evaluated a patient-reported 0 to 10 score of IBD activity ( IBD-10 ) by correlation with conventional multicomponent activity indices . Methods : A single-center prospect i ve cross-sectional study was conducted in ambulant patients with IBD . Patients were asked to verbally rate the control of Crohn 's disease ( CD ) or ulcerative colitis ( UC ) on a numerical scale from 0 to 10 , with 10 indicating perfect control . Disease activity was assessed using Harvey – Bradshaw index for CD and simple clinical colitis activity index for UC . Results : A total of 405 patients were included , of whom 209 ( 52 % ) had CD and 196 ( 48 % ) had UC . The median age was 41 ( interquartile range , 27–55 ) years . IBD-10 correlated well with Harvey – Bradshaw Index ( rs = −0.69 , P < 0.001 ) and simple clinical colitis activity index ( rs = −0.79 , P < 0.001 ) . An IBD-10 score of ≥7 predicted remission ( defined by Harvey – Bradshaw index/simple clinical colitis activity index ) with 90 % sensitivity ( 95 % confidence interval [ CI ] , 86–94 ) and 75 % specificity ( 95 % CI , 67–82 ) . The discriminatory ability of IBD-10 for remission was better for UC ( area under the receiver operating characteristic curve , 0.93 ; 95 % CI , 0.89–0.97 ) than for CD ( area under the receiver operating characteristic curve , 0.86 ; 95 % CI , 0.81–0.91 ; P = 0.035 ) . An IBD-10 score of < 7 correlated with treatment escalation . Conclusions : The IBD-10 score correlates well with more complex clinical activity indices . Correlation was less strong for CD than for UC , possibly reflecting a weaker link in CD between stool frequency and the patient perspective of disease activity . The IBD-10 score could readily be used in routine clinical practice Background Current instruments used to measure disease activity and health-related quality of life in patients with Crohn ’s disease ( CD ) and ulcerative colitis ( UC ) are often cumbersome , time-consuming , and expensive ; although used in clinical trials , they are not convenient for clinical practice . A  numeric rating scale ( NRS ) is a quick , inexpensive , and convenient patient-reported outcome that can capture the patient ’s overall perception of health . Aims The aim of this study was to assess the validity , reliability , and responsiveness of an NRS and evaluate its use in clinical practice in patients with CD and UC . Methods We prospect ively evaluated  patient-reported NRS scores  and measured correlations between NRS and a range of severity measures , including  physician-reported NRS , Crohn ’s disease activity index ( CDAI ) , Harvey-Bradshaw index ( HBI ) , inflammatory bowel disease question naire ( IBDQ ) , and C-reactive protein ( CRP ) in patients with CD . Subsequently , we evaluated the correlation between the NRS and st and ard measures of health status ( HBI or simple colitis clinical activity index [ SCCAI ] ) and laboratory tests ( sedimentation rate [ ESR ] , CRP , and fecal calprotectin ) in patients with CD and UC . Results The patient-reported NRS showed excellent correlation with CDAI ( R2 = 0.59 , p < 0.0001 ) , IBDQ ( R2 = 0.66 , p < 0.0001 ) , and HBI ( R2 = 0.32 , p < 0.0001 ) in patients with CD . The NRS showed poor , but statistically significant correlation with SCCAI ( R2 = 0.25 , p < 0.0001 ) in patients with UC . The NRS did not correlate with CRP , ESR , or calprotectin . The NRS was reliable and responsive to change . Conclusions The NRS is a valid , reliable , and responsive measure that may be useful to evaluate patients with CD and possibly UC Goals and Background : The objective is to develop a patient-based Harvey Bradshaw Index ( P-HBI ) of Crohn ’s Disease ( CD ) activity and to compare it with the clinician-based HBI of CD activity in CD out patients . Study : Consecutive patients with CD r and omly completed the P-HBI either before or after the consultation .  The gastroenterologist assessed patient ’s CD activity on the same day . Overall agreement between HBI and P-HBI was calculated with Spearman ’s & rgr ; and Mann-Whitney U test . Agreement regarding active disease versus remission and agreement at item level was calculated by percent agreement and Cohen ’s & kgr;. Results : One hundred eighty-one ( response rate 88.3 % ) CD patients participated . P-HBI and HBI showed a large correlation ( rs=0.82 ) . The medians ( interquartile range ) of the total HBI ( 2 ; 0 to 4 ) and P-HBI ( 4 ; 1 to 7 ) were statistically significantly different ( z=−8.411 ; P<0.001 ) . Fortunately , in 82.6 % of the cases this difference between clinicians and patients was not clinical ly significant ( < 3.2 ) . The percentage agreement between clinician and patient , judging CD as active or as in remission , was 77 % , rs=0.56 , & kgr;=0.52 , indicating a moderate agreement .  P-HBI and HBI on frequent extraintestinal manifestations in CD varied from less than chance ( & kgr;=−0.02 ) to a perfect agreement ( & kgr;=1 ) . Patients tended to report more symptoms while completing the patient-based question naire compared to what they reported to the clinician during consultation . Conclusions : The P-HBI is the first step in developing a potential promising tool given its adequate agreement with the original HBI and its feasibility , especially in patients with low scores . Future research is necessary to develop a vali date d patient-based version studied in several patient population The Crohn 's Disease Activity Index ( CDAI ) is a measure of disease activity based on symptoms , signs and a laboratory test . The US Food and Drug Administration has indicated that patient reported outcomes ( PROs ) should be the primary outcome in r and omised controlled trials for Crohn 's disease ( CD ) 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 r and omly 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 clinical ly 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 Objectives : Currently vali date d ulcerative colitis ( UC ) activity measures are physician based , but incorporate patient reports of symptoms . We aim ed to assess whether patient-completed  Pediatric UC Activity Index ( PUCAI ) scores are comparable to those of physician scores . Patients and Methods : We performed a single-center prospect i ve study to assess agreement between patient- and physician-completed PUCAI scores .  Seventy patients with UC ( ages 4–29 ) representative of all of the disease activity categories ( inactive , mild , moderate , and severe ) in the currently published physician-completed scoring system were recruited . Agreement was analyzed for PUCAI scores both as continuous and categorical measures . To ascertain validity , we compared both patient- and physician-completed PUCAI scores with the physician global assessment and serum inflammatory markers . Results : Patient- and physician-completed PUCAI summary scores were identical 49 % of the time , were different but within the minimal clinical ly important difference ( MCID ) of 20 points 48 % of the time , and were at or beyond the MCID only 3 % of the time . In general , patients reported higher mean disease severity on their question naires than did their physicians , with a mean difference in PUCAI scores of 3 ± 8 ( 95 % confidence interval 2%–5 % ) . A categorical comparison of the 2 sets of question naires using the disease activity groups demonstrated perfect agreement for 60 ( 86 % ) pairs ( kappa coefficient 0.78 ; 95 % confidence interval 0.65%–0.90 % ) . Both patient- and physician-completed PUCAI scores also correlated well with the physician global assessment and serum inflammatory markers . Conclusions : Our data indicate strong agreement between PUCAI scores obtained directly from patients and those completed by physicians . Hence , a patient-based PU 
    Output:
    
The mobile health index for CD and UC scores had the best measurement properties for use in clinical practice and in clinical trials .