Publication: Validation of models using basic parameters to differentiate intestinal tuberculosis from Crohn’s disease: A multicenter study from Asia
3
Issued Date
2020-11-01
Resource Type
ISSN
19326203
Other identifier(s)
2-s2.0-85097037464
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
PLoS ONE. Vol.15, No.11 November (2020)
Suggested Citation
Julajak Limsrivilai, Choon Kin Lee, Piyapan Prueksapanich, Kamin Harinwan, Asawin Sudcharoen, Natcha Cheewasereechon, Satimai Aniwan, Pimsiri Sripongpan, Panu Wetwittayakhlang, Ananya Pongpaibul, Anapat Sanpavat, Nonthalee Pausawasdi, Phunchai Charatcharoenwitthaya, Peter D.R. Higgins, Siew Chien Ng Validation of models using basic parameters to differentiate intestinal tuberculosis from Crohn’s disease: A multicenter study from Asia. PLoS ONE. Vol.15, No.11 November (2020). doi:10.1371/journal.pone.0242879 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/60355
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Validation of models using basic parameters to differentiate intestinal tuberculosis from Crohn’s disease: A multicenter study from Asia
Abstract
© 2020 Limsrivilai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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.