Validation of the 'Inflammatory Bowel Disease-Distribution, Chronicity, Activity [IBD-DCA] Score' for Ulcerative Colitis and Crohn ' s Disease

C. Lang-Schwarz, M. Angeloni, A. Agaimy, R. Atreya, C. Becker, T. Dregelies, S. Danese, J.F. Flejou, N. Gassler, H.I. Grabsch, A. Hartmann, K. Kamaradova, A.A. Kuhl, G.Y. Lauwers, A. Lugli, I. Nagtegaal, M.F. Neurath, G. Oberhuber, L. Peyrin-Biroulet, T. RathR. Riddell, C.A. Rubio, K. Sheahan, B. Siegmund, H. Tilg, V. Villanacci, M. Westerhoff, F. Ferrazzi, M. Vieth*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background and Aims: Histological scoring plays a key role in the assessment of disease activity in ulcerative colitis [UC] and is also important in Crohns disease [CD]. Currently, there is no common scoring available for UC and CD. We aimed to validate the Inflammatory Bowel Disease [IBD]-Distribution [D], Chronicity [C], Activity [A] score [IBD-DCA score] for histological disease activity assessment in IBD.Methods: Inter- and intra-rater reliability were assessed by 16 observers on biopsy specimens from 59 patients with UC and 25 patients with CD. Construct validity and responsiveness to treatment were retrospectively evaluated in a second cohort of 30 patients.Results: Inter-rater reliability was moderate to good for the UC cohort (intraclass correlation coefficients [ICCs]=0.645, 0.623, 0.767 for D, C, and A, respectively) and at best moderate for the CD cohort [ICC=0.690, 0.303, 0.733 for D, C, and A, respectively]. Intra-rater agreement ranged from good to excellent in both cohorts. Correlation with the Nancy Histological Index [NHI] was moderate and strong with the Simplified Geboes Score [SGS] and a Visual Analogue Scale [VAS], respectively. Large effect sizes were obtained for all three parameters. External responsiveness analysis revealed correlated changes between IBD-DCA score and NHI, SGS and VAS.Conclusions: The IBD-DCA score is a simple histological activity score for UC and CD, agreed and validated by a large group of IBD specialists. It provides reliable information on treatment response. Therefore, it has potential value for use in routine diagnostics as well as clinical studies.
Original languageEnglish
Pages (from-to)1621-1630
Number of pages10
JournalJournal of Crohn's & Colitis
Issue number10
Publication statusPublished - 1 Oct 2021


  • Histological index
  • inflammatory bowel disease

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