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Validation of models using basic parameters to differentiate intestinal tuberculosis from Crohn’s disease: A multicenter study from Asia

BACKGROUND: Data on external validation of models developed to distinguish Crohn’s disease (CD) from intestinal tuberculosis (ITB) are limited. This study aimed to validate and compare models using clinical, endoscopic, and/or pathology findings to differentiate CD from ITB. METHODS: Data from newly...

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Autores principales: Limsrivilai, Julajak, Lee, Choon Kin, Prueksapanich, Piyapan, Harinwan, Kamin, Sudcharoen, Asawin, Cheewasereechon, Natcha, Aniwan, Satimai, Sripongpan, Pimsiri, Wetwittayakhlang, Panu, Pongpaibul, Ananya, Sanpavat, Anapat, Pausawasdi, Nonthalee, Charatcharoenwitthaya, Phunchai, Higgins, Peter D. R., Ng, Siew Chien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7703980/
https://www.ncbi.nlm.nih.gov/pubmed/33253239
http://dx.doi.org/10.1371/journal.pone.0242879
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author Limsrivilai, Julajak
Lee, Choon Kin
Prueksapanich, Piyapan
Harinwan, Kamin
Sudcharoen, Asawin
Cheewasereechon, Natcha
Aniwan, Satimai
Sripongpan, Pimsiri
Wetwittayakhlang, Panu
Pongpaibul, Ananya
Sanpavat, Anapat
Pausawasdi, Nonthalee
Charatcharoenwitthaya, Phunchai
Higgins, Peter D. R.
Ng, Siew Chien
author_facet Limsrivilai, Julajak
Lee, Choon Kin
Prueksapanich, Piyapan
Harinwan, Kamin
Sudcharoen, Asawin
Cheewasereechon, Natcha
Aniwan, Satimai
Sripongpan, Pimsiri
Wetwittayakhlang, Panu
Pongpaibul, Ananya
Sanpavat, Anapat
Pausawasdi, Nonthalee
Charatcharoenwitthaya, Phunchai
Higgins, Peter D. R.
Ng, Siew Chien
author_sort Limsrivilai, Julajak
collection PubMed
description BACKGROUND: Data on external validation of models developed to distinguish Crohn’s disease (CD) from intestinal tuberculosis (ITB) are limited. This study aimed to validate and compare models using clinical, endoscopic, and/or pathology findings to differentiate CD from ITB. METHODS: Data from newly diagnosed ITB and CD patients were retrospectively collected from 5 centers located in Thailand or Hong Kong. The data was applied to Lee, et al., Makharia, et al., Jung, et al., and Limsrivilai, et al. model. RESULTS: Five hundred and thirty patients (383 CD, 147 ITB) with clinical and endoscopic data were included. The area under the receiver operating characteristic curve (AUROC) of Limsrivilai’s clinical-endoscopy (CE) model was 0.853, which was comparable to the value of 0.862 in Jung’s model (p = 0.52). Both models performed significantly better than Lee’s endoscopy model (AUROC: 0.713, p<0.01). Pathology was available for review in 199 patients (116 CD, 83 ITB). When 3 modalities were combined, Limsrivilai’s clinical-endoscopy-pathology (CEP) model performed significantly better (AUROC: 0.887) than Limsrivilai’s CE model (AUROC: 0.824, p = 0.01), Jung’s model (AUROC: 0.798, p = 0.005) and Makharia’s model (AUROC: 0.637, p<0.01). In 83 ITB patients, the rate of misdiagnosis with CD when used the proposed cutoff values in each original study was 9.6% for Limsrivilai’s CEP, 15.7% for Jung’s, and 66.3% for Makharia’s model. CONCLUSIONS: Scoring systems with more parameters and diagnostic modalities performed better; however, application to clinical practice is still limited owing to high rate of misdiagnosis of ITB as CD. Models integrating more modalities such as imaging and serological tests are needed.
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spelling pubmed-77039802020-12-03 Validation of models using basic parameters to differentiate intestinal tuberculosis from Crohn’s disease: A multicenter study from Asia Limsrivilai, Julajak Lee, Choon Kin Prueksapanich, Piyapan Harinwan, Kamin Sudcharoen, Asawin Cheewasereechon, Natcha Aniwan, Satimai Sripongpan, Pimsiri Wetwittayakhlang, Panu Pongpaibul, Ananya Sanpavat, Anapat Pausawasdi, Nonthalee Charatcharoenwitthaya, Phunchai Higgins, Peter D. R. Ng, Siew Chien PLoS One Research Article BACKGROUND: Data on external validation of models developed to distinguish Crohn’s disease (CD) from intestinal tuberculosis (ITB) are limited. This study aimed to validate and compare models using clinical, endoscopic, and/or pathology findings to differentiate CD from ITB. METHODS: Data from newly diagnosed ITB and CD patients were retrospectively collected from 5 centers located in Thailand or Hong Kong. The data was applied to Lee, et al., Makharia, et al., Jung, et al., and Limsrivilai, et al. model. RESULTS: Five hundred and thirty patients (383 CD, 147 ITB) with clinical and endoscopic data were included. The area under the receiver operating characteristic curve (AUROC) of Limsrivilai’s clinical-endoscopy (CE) model was 0.853, which was comparable to the value of 0.862 in Jung’s model (p = 0.52). Both models performed significantly better than Lee’s endoscopy model (AUROC: 0.713, p<0.01). Pathology was available for review in 199 patients (116 CD, 83 ITB). When 3 modalities were combined, Limsrivilai’s clinical-endoscopy-pathology (CEP) model performed significantly better (AUROC: 0.887) than Limsrivilai’s CE model (AUROC: 0.824, p = 0.01), Jung’s model (AUROC: 0.798, p = 0.005) and Makharia’s model (AUROC: 0.637, p<0.01). In 83 ITB patients, the rate of misdiagnosis with CD when used the proposed cutoff values in each original study was 9.6% for Limsrivilai’s CEP, 15.7% for Jung’s, and 66.3% for Makharia’s model. CONCLUSIONS: Scoring systems with more parameters and diagnostic modalities performed better; however, application to clinical practice is still limited owing to high rate of misdiagnosis of ITB as CD. Models integrating more modalities such as imaging and serological tests are needed. Public Library of Science 2020-11-30 /pmc/articles/PMC7703980/ /pubmed/33253239 http://dx.doi.org/10.1371/journal.pone.0242879 Text en © 2020 Limsrivilai et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Limsrivilai, Julajak
Lee, Choon Kin
Prueksapanich, Piyapan
Harinwan, Kamin
Sudcharoen, Asawin
Cheewasereechon, Natcha
Aniwan, Satimai
Sripongpan, Pimsiri
Wetwittayakhlang, Panu
Pongpaibul, Ananya
Sanpavat, Anapat
Pausawasdi, Nonthalee
Charatcharoenwitthaya, Phunchai
Higgins, Peter D. R.
Ng, Siew Chien
Validation of models using basic parameters to differentiate intestinal tuberculosis from Crohn’s disease: A multicenter study from Asia
title Validation of models using basic parameters to differentiate intestinal tuberculosis from Crohn’s disease: A multicenter study from Asia
title_full Validation of models using basic parameters to differentiate intestinal tuberculosis from Crohn’s disease: A multicenter study from Asia
title_fullStr Validation of models using basic parameters to differentiate intestinal tuberculosis from Crohn’s disease: A multicenter study from Asia
title_full_unstemmed Validation of models using basic parameters to differentiate intestinal tuberculosis from Crohn’s disease: A multicenter study from Asia
title_short Validation of models using basic parameters to differentiate intestinal tuberculosis from Crohn’s disease: A multicenter study from Asia
title_sort validation of models using basic parameters to differentiate intestinal tuberculosis from crohn’s disease: a multicenter study from asia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7703980/
https://www.ncbi.nlm.nih.gov/pubmed/33253239
http://dx.doi.org/10.1371/journal.pone.0242879
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