ECCO Fellowship Study Synopsis: Ferdinando D'Amico
Ferdinando D'Amico, ECCO Fellowship Awardee
Comparative accuracy of the standard Lémann index versus the simplified Lémann index for Crohn’s Disease: a prospective observational cohort study
© Ferdinando D'Amico
Aim of research
Crohn's Disease (CD) is an idiopathic Inflammatory Bowel Disease (IBD) characterised by transmural inflammation of the affected tracts. The uncontrolled inflammation can lead to bowel damage, defined as the onset of strictures, abscesses or fistulas negatively impacting patients' quality of life and outcomes. The Lémann index (LI) is a recently validated tool that was specifically designed to assess the presence of penetrating or stenosing lesions and to quantify their severity. LI is a complex and time-consuming score which is based on imaging [magnetic resonance imaging (MRI)] and endoscopic procedures. Of note, it is mainly used in clinical trials, while its use in clinical practice is limited. Our aim was to develop a simplified LI and to compare the correlation between this simplified LI and the standard LI in assessing bowel damage.
This is an observational cohort study conducted at Nancy University Hospital (France). All adult patients with a confirmed diagnosis of ileocolonic CD who undergo colonoscopy and MRI will be eligible for inclusion. Three gastroenterologists, two radiologists and one statistician participated in a meeting held in Nancy in March 2020 to derive a simplified LI from the original LI. The simplified score will include only MRI findings and will be based on a reduced number of evaluated segments compared with the traditional score. The correlation between the simplified LI and the validated LI will be assessed by comparing data from 200 CD patients. Parametric and non-parametric tests will be used for analysis of the study outcomes. Any difference will be considered statistically significant if p<0.05.
Anticipated main impact
A simplified LI could allow for non-invasive assessment of bowel damage and be easily used in clinical practice to guide the management of CD patients.
The study is expected to be completed in June 2021.