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Development and validation of risk matrices for Crohn's Disease outcomes in patients who underwent early therapeutic interventions

dc.contributor.authorDias, Cláudia Camila
dc.contributor.authorRodrigues, Pedro Pereira
dc.contributor.authorCoelho, Rosa
dc.contributor.authorSantos, Paula Moura
dc.contributor.authorFernandes, Samuel
dc.contributor.authorLago, Paula
dc.contributor.authorCaetano, Cidalina
dc.contributor.authorRodrigues, Angela
dc.contributor.authorPortela, Francisco
dc.contributor.authorOliveira, Ana
dc.contributor.authorMinistro, Paula
dc.contributor.authorCancela, Eugenia
dc.contributor.authorVieira, Ana Isabel
dc.contributor.authorBarosa, Rita
dc.contributor.authorCotter, Jose
dc.contributor.authorCarvalho, Pedro
dc.contributor.authorCremers, Isabelle
dc.contributor.authorTrabulo, Daniel
dc.contributor.authorCaldeira, Paulo
dc.contributor.authorAntunes, Artur
dc.contributor.authorRosa, Isadora
dc.contributor.authorMoleiro, Joana
dc.contributor.authorPeixe, Paula
dc.contributor.authorHerculano, Rita
dc.contributor.authorGonçalves, Raquel
dc.contributor.authorGonçalves, Bruno
dc.contributor.authorSousa, Helena Tavares
dc.contributor.authorContente, Luis
dc.contributor.authorMorna, Henrique
dc.contributor.authorLopes, Susana
dc.contributor.authorMagro, Fernando
dc.date.accessioned2019-11-20T15:07:42Z
dc.date.available2019-11-20T15:07:42Z
dc.date.issued2017-04
dc.description.abstractIntroduction: The establishment of prognostic models for Crohn's disease [CD] is highly desirable, as they have the potential to guide physicians in the decision-making process concerning therapeutic choices, thus improving patients' health and quality of life. Our aim was to derive models for disabling CD and reoperation based solely on clinical/demographic data. Methods: A multicentric and retrospectively enrolled cohort of CD patients, subject to early surgery or immunosuppression, was analysed in order to build Bayesian network models and risk matrices. The final results were validated internally and with a multicentric and prospectively enrolled cohort. Results: The derivation cohort included a total of 489 CD patients [64% with disabling disease and 18% who needed reoperation], while the validation cohort included 129 CD patients with similar outcome proportions. The Bayesian models achieved an area under the curve of 78% for disabling disease and 86% for reoperation. Age at diagnosis, perianal disease, disease aggressiveness and early therapeutic decisions were found to be significant factors, and were used to construct user-friendly matrices depicting the probability of each outcome in patients with various combinations of these factors. The matrices exhibit good performance for the most important criteria: disabling disease positive post-test odds = 8.00 [2.72-23.44] and reoperation negative post-test odds = 0.02 [0.00-0.11]. Conclusions: Clinical and demographical risk factors for disabling CD and reoperation were determined and their impact was quantified by means of risk matrices, which are applicable as bedside clinical tools that can help physicians during therapeutic decisions in early disease management.
dc.description.sponsorshipGEDII - Grupo de Estudo da Doenca Inflamatoria Intestinal
dc.description.versioninfo:eu-repo/semantics/publishedVersion
dc.identifier.doi10.1093/ecco-jcc/jjw171
dc.identifier.issn1873-9946
dc.identifier.issn1876-4479
dc.identifier.urihttp://hdl.handle.net/10400.1/13174
dc.language.isoeng
dc.peerreviewedyes
dc.publisherOxford University Press
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectInflammatory-bowel-disease
dc.subjectIntestinal resection
dc.subjectBayesian networks
dc.subjectPredictors
dc.subjectMetaanalysis
dc.subjectPackage
dc.subjectCare
dc.titleDevelopment and validation of risk matrices for Crohn's Disease outcomes in patients who underwent early therapeutic interventions
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage453
oaire.citation.issue4
oaire.citation.startPage445
oaire.citation.titleJournal of Crohns & Colitis
oaire.citation.volume11
person.familyNameCaldeira
person.familyNameAntunes
person.familyNameSousa
person.givenNamePaulo
person.givenNameArtur
person.givenNameHelena Tavares
person.identifier.ciencia-id1112-F0B2-19A3
person.identifier.ciencia-idCF1F-1163-1C4A
person.identifier.orcid0000-0002-2404-6295
person.identifier.orcid0000-0001-7098-6125
person.identifier.orcid0000-0002-6626-205X
rcaap.rightsrestrictedAccess
rcaap.typearticle
relation.isAuthorOfPublication3def3720-8982-4c46-801d-af640d508b59
relation.isAuthorOfPublication2fffeff1-6705-431b-87e7-eb06146e2204
relation.isAuthorOfPublication6b1d11dd-486f-4fb3-b41f-02e1cf6a5c2e
relation.isAuthorOfPublication.latestForDiscovery6b1d11dd-486f-4fb3-b41f-02e1cf6a5c2e

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