Evidence map›Paper›PMID 32981088›Full record

ArticleAlimentary pharmacology & therapeutics2020

Evaluating the optimum number of biopsies to assess histological inflammation in ulcerative colitis: a retrospective cohort study.

Robert Battat, Niels Vande Casteele, Rish K Pai, Zhongya Wang, Guangyong Zou, John W D McDonald, Marjolijn Duijvestein, Jenny Jeyarajah, Claire E Parker, Tanja Van Viegen and 8 more

Abstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Alimentary pharmacology & therapeutics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
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  3. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Robert BattatDivision of Gastroenterology, University of California San Diego, La Jolla, CA, USA.ORCID 0000-0002-7421-9764
Niels Vande CasteeleDivision of Gastroenterology, University of California San Diego, La Jolla, CA, USA.
Rish K PaiDepartment of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, AZ, USA.ORCID 0000-0002-2692-221X
Zhongya WangAlimentiv Inc. (formerly Robarts Clinical Trials Inc.), London, ON, Canada.
Guangyong ZouAlimentiv Inc. (formerly Robarts Clinical Trials Inc.), London, ON, Canada.
John W D McDonaldAlimentiv Inc. (formerly Robarts Clinical Trials Inc.), London, ON, Canada.
Marjolijn DuijvesteinAlimentiv Inc. (formerly Robarts Clinical Trials Inc.), London, ON, Canada.
Jenny JeyarajahAlimentiv Inc. (formerly Robarts Clinical Trials Inc.), London, ON, Canada.ORCID 0000-0001-8510-2281
Claire E ParkerAlimentiv Inc. (formerly Robarts Clinical Trials Inc.), London, ON, Canada.ORCID 0000-0002-8587-5441
Tanja Van ViegenAlimentiv Inc. (formerly Robarts Clinical Trials Inc.), London, ON, Canada.
Sigrid A NelsonAlimentiv Inc. (formerly Robarts Clinical Trials Inc.), London, ON, Canada.
Brigid S BolandDivision of Gastroenterology, University of California San Diego, La Jolla, CA, USA.
Siddharth SinghDivision of Gastroenterology, University of California San Diego, La Jolla, CA, USA.ORCID 0000-0002-2640-7269
Parambir S DulaiDivision of Gastroenterology, University of California San Diego, La Jolla, CA, USA.ORCID 0000-0002-9514-2321
Mark A ValasekDepartment of Pathology, University of California San Diego, La Jolla, CA, USA.
Brian G FeaganAlimentiv Inc. (formerly Robarts Clinical Trials Inc.), London, ON, Canada.ORCID 0000-0002-6914-3822
Vipul JairathAlimentiv Inc. (formerly Robarts Clinical Trials Inc.), London, ON, Canada.ORCID 0000-0002-1092-0033
William J SandbornDivision of Gastroenterology, University of California San Diego, La Jolla, CA, USA.ORCID 0000-0002-3314-7960

Funding

San Diego Digestive Diseases Research CenterP30DK120515 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LARS ECKMANN · 2019 to 2026
$10.8M
Comparative Risks and Benefits of Pharmacological Therapies for Older Patients with Inflammatory Bowel DiseasesK23DK117058 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SINGH, SIDDHARTH · 2018 to 2022
$971k
USING SINGLE-CELL RNA AND PROTEIN APPROACHES TO ELUCIDATE MOLECULAR DETERMINANTSAND PREDICTORS OF INFLAMMATORY BOWEL DISEASESK23DK123406 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BOLAND, BRIGID S · 2020 to 2022
$720k
NIDDK NIH HHS K23 DK117058NIDDK NIH HHS K23 DK123406NIDDK NIH HHS P30 DK120515
6 · The paper itself

Abstract

backgroundThe optimal ulcerative colitis biopsy protocol is unclear.

aimTo evaluate the number of biopsies required to accurately assess microscopic disease activity in ulcerative colitis

methodsBiopsies from patients with ≥4 rectosigmoid samples, and clinical and endoscopic data, were retrospectively obtained from a prospective biobank. Histology and endoscopic videos were read blindly. A 4-biopsy Robarts Histopathology Index (RHI) reference score, consisting of the worst item-level ratings from four biopsies, was compared to 1-, 2- and 3-biopsy estimates. Agreement was determined using bivariate errors-in-variable regression analysis (acceptance interval: ±8.25). Endoscopic activity and disease location subgroup analyses were also performed.

resultsForty-six patients had ≥4 rectosigmoid biopsies available (N = 287). The 2-biopsy (tolerance interval: -7.66, 4.79) and 3-biopsy (tolerance interval: -4.86, 3.46) RHI scores demonstrated acceptable agreement with 4-biopsy scores. One-biopsy scores demonstrated unacceptable agreement (tolerance interval: -13.99, 7.78). Mean RHI scores using the 2-, 3- and 4-biopsy approaches were similar (6.1 ± 9.6 P = 0.36; 6.8 ± 10.5, P = 0.7; 7.5 ± 11.2), whereas the 1-biopsy estimate was lower (4.4 ± 8.1, P = 0.06). Histological remission rates were identical for the 2-, 3- and 4-biopsy methods (65.2%, P = 1.0). Subgroup analysis demonstrated that three biopsies were required in patients with endoscopically active disease. Sampling additional colonic locations yielded lower histological remission rates compared to rectosigmoid sampling alone (33.3% vs 61.9%, P = 0.1).

conclusionsA minimum of two - conservatively, three - biopsies are required to reliably assess disease activity in a single colonic segment using the RHI. Further studies are needed of endoscopically active patients and sampling locations. These results have implications for biopsy strategies in clinical trials and practice.

Indexed as

AdultBiopsyCalibrationCohort StudiesColitis, UlcerativeColon, SigmoidFemaleHistological TechniquesHumansInflammationMaleMiddle AgedPatient ParticipationProspective StudiesRectumReoperation

Identifiers

PMID32981088
PMCPMC8007067

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.