Diverticular Inflammation and Complication Assessment classification, CODA score and fecal calprotectin in clinical assessment of patients with diverticular disease: A decision curve analysis

التفاصيل البيبلوغرافية
العنوان: Diverticular Inflammation and Complication Assessment classification, CODA score and fecal calprotectin in clinical assessment of patients with diverticular disease: A decision curve analysis
المؤلفون: Tursi, Antonio, Piovani, Daniele, Brandimarte, Giovanni, Mario, Francesco, Elisei, Walter, Picchio, Marcello, Allegretta, Leonardo, Annunziata, Maria Laura, Bafutto, Mauro, Bassotti, Gabrio, Bianco, Maria Antonia, Colucci, Raffaele, Conigliaro, Rita, Dumitrascu, Dan L., Escalante, Ricardo, Ferrini, Luciano, Forti, Giacomo, Franceschi, Marilisa, Graziani, Maria Giovanna, Lammert, Frank, Latella, Giovanni, Maconi, Giovanni, Compare, Debora, Nardone, Gerardo, Camara De Castro Oliveira, Lucia, Oliveira, Enio Chaves, Papa, Alfredo, Papagrigoriadis, Savvas, Pietrzak, Anna, Pontone, Stefano, Poskus, Tomas, Pranzo, Giuseppe, Reichert, Matthias Christian, Rodinò, Stefano, Regula, Jaroslaw, Scaccianoce, Giuseppe, Scaldaferri, Franco, Vassallo, Roberto, Zampaletta, Costantino, Zullo, Angelo, Spaziani, Erasmo, Bonovas, Stefanos, Danese, Silvio, Astegiano, Marco, Bachetti, Francesco, Baldassarre, Gianluca, Baldi, Fabio, Borsotti, Edoardo, Cassieri, Claudio, Cazzato, Alessia, Chiri, Stefania, Ciccone, Antonio, Damiani, Alberto, Colibus, Patrizia De, Faggiani, Roberto, Finocchiaro, Fabio, Fiorella, Serafina, Foschia, Francesca, Furfaro, Federica, Gallina, Sara, Giorgetti, Gian Marco, Grad, Simona, Grande, Giuseppe, Grandolfo, Antonio, Lai, Maria Antonia, Lecca, Piera Giuseppina, Lisi, Daniele, Lopetuso, Loris Riccardo, Penna, Antonio, Pigò, Flavia, Portincasa, Piero, Rizzatti, Giannenrico, Rizzo, Giovanni Luca, Scanni, Stefania, Schiffino, Luigi, Stundiene, Ieva, Tesoriere, Antonino, Urgesi, Riccardo, Usai, Paolo
المصدر: United European Gastroenterology Journal; September 2023, Vol. 11 Issue: 7 p642-653, 12p
مستخلص: The Diverticular Inflammation and Complication Assessment (DICA) classification and the Combined Overview on Diverticular Assessment (CODA) were found to be effective in predicting the outcomes of Diverticular Disease (DD). We ascertain whether fecal calprotectin (FC) can further aid in improving risk stratification. A three‐year international, multicentre, prospective cohort study was conducted involving 43 Gastroenterology and Endoscopy centres. Survival methods for censored observations were used to estimate the risk of acute diverticulitis (AD) in newly diagnosed DD patients according to basal FC, DICA, and CODA. The net benefit of management strategies based on DICA, CODA and FC in addition to CODA was assessed with decision curve analysis, which incorporates the harms and benefits of using a prognostic model for clinical decisions. At the first diagnosis of diverticulosis/DD, 871 participants underwent FC measurement. FC was associated with the risk of AD at 3 years (HR per each base 10 logarithm increase: 3.29; 95% confidence interval, 2.13–5.10) and showed moderate discrimination (c‐statistic: 0.685; 0.614–0.756). DICA and CODA were more accurate predictors of AD than FC. However, FC showed high discrimination capacity to predict AD at 3 months, which was not maintained at longer follow‐up times. The decision curve analysis comparing the combination of FC and CODA with CODA alone did not clearly indicate a larger net benefit of one strategy over the other. FC measurement could be used as a complementary tool to assess the immediate risk of AD. In all other cases, treatment strategies based on the CODA score alone should be recommended.
قاعدة البيانات: Supplemental Index
الوصف
تدمد:20506406
20506414
DOI:10.1002/ueg2.12369