Observational studyGastroenterology2021
Validation and Update of the Lémann Index to Measure Cumulative Structural Bowel Damage in Crohn's Disease.
Observational study in Gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 21 papers.
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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.
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Who cites it
21 citing papers in PubMed, 46 citations in OpenAlex.
- Inequities in inflammatory bowel disease care: a Tasmanian case study with proposed solutions.Internal medicine journal · 2026Review
- Knowledge and acceptability of the Lémann Index as a tool to measure disease progression and bowel damage in Crohn's disease: results from an international survey.Intestinal research · 2025Article
- Mesenteric fat proliferation on magnetic resonance enterography is a predictor of long-term disease complications in crohn's disease.BMC gastroenterology · 2025Article
- Novel outcomes in inflammatory bowel disease.Journal of Crohn's & colitis · 2025Review
- Integrating Gut Microbiome and Metabolomics with Magnetic Resonance Enterography to Advance Bowel Damage Prediction in Crohn's Disease.Journal of inflammation research · 2025Article
- The CROCO (CROhn's Disease COhort Study) - study design and protocol.Therapeutic advances in gastroenterology · 2025Article
- Development and Validation of a CTE-Based Radiomics Nomogram for Predicting Clinical Adverse Outcomes in Patients with Stricturing Crohn's Disease.Journal of inflammation research · 2025Article
- Transmural cross-sectional findings and bowel damage assessment in preclinical Crohn's disease: a case-control study.International journal of colorectal disease · 2024Article
- Challenges in IBD Research 2024: Precision Medicine.Inflammatory bowel diseases · 2024Review
- The Earlier You Find, the Better You Treat: Red Flags for Early Diagnosis of Inflammatory Bowel Disease.Diagnostics (Basel, Switzerland) · 2023Review
- Macrophages in intestinal homeostasis and inflammatory bowel disease.Nature reviews. Gastroenterology & hepatology · 2023Review
- Prospective Validation of the Lémann Index in Children: A Report From the Multicentre Image Kids Study.Journal of Crohn's & colitis · 2023Article
- Precision medicine and drug optimization in adult inflammatory bowel disease patients.Therapeutic advances in gastroenterology · 2023Review
- A Summary of the BRIDGe Summit on Damage-Related Progression of Ulcerative Colitis: Establishing Research Priorities.Gastroenterology · 2022Article
- Review
- Predictors of bowel damage in the long-term progression of Crohn's disease.World journal of clinical cases · 2022Article
- IL-23 Blockade in Anti-TNF Refractory IBD: From Mechanisms to Clinical Reality.Journal of Crohn's & colitis · 2022Review
- Early Post-Operative Endoscopy Is Associated with Lower Surgical Recurrence of Crohn's Disease: A Retrospective Study of Three Successive Cohorts.Gastroenterology research and practice · 2022Article
- A scoping review on early inflammatory bowel disease: definitions, pathogenesis, and impact on clinical outcomes.Therapeutic advances in gastroenterology · 2022Article
- Mucosal Healing in Crohn's Disease: Bull's Eye or Bust? "The Pro Position".Inflammatory intestinal diseases · 2022Review
Corrections and comments
- Commented on by
- Erratum issuedCorrection.2021
Authors and funding
26 authors at 18 institutions in 12 countries.
Funding
Abstract
BACKGROUND &
aimsThe Lémann Index is a tool measuring cumulative structural bowel damage in Crohn's disease (CD). We reported on its validation and updating.
methodsThis was an international, multicenter, prospective, cross-sectional observational study. At each center, 10 inclusions, stratified by CD duration and location, were planned. For each patient, the digestive tract was divided into 4 organs, upper tract, small bowel, colon/rectum, anus, and subsequently into segments, explored systematically by magnetic resonance imaging and by endoscopies in relation to disease location. For each segment, investigators retrieved information on previous surgical procedures, identified predefined strictures and penetrating lesions of maximal severity (grades 1-3) at each organ investigational method (gastroenterologist and radiologist for magnetic resonance imaging), provided segmental damage evaluation ranging from 0.0 to 10.0 (complete resection). Organ resection-free cumulative damage evaluation was then calculated from the sum of segmental damages. Then investigators provided a 0-10 global damage evaluation from the 4-organ standardized cumulative damage evaluations. Simple linear regressions of investigator damage evaluations on their corresponding Lémann Index were studied, as well as calibration plots. Finally, updated Lémann Index was derived through multiple linear mixed models applied to combined development and validation samples.
resultsIn 15 centers, 134 patients were included. Correlation coefficients between investigator damage evaluations and Lémann Indexes were >0.80. When analyzing data in 272 patients from both samples and 27 centers, the unbiased correlation estimates were 0.89, 0,97, 0,94, 0.81, and 0.91 for the 4 organs and globally, and stable when applied to one sample or the other.
conclusionsThe updated Lémann Index is a well-established index to assess cumulative bowel damage in CD that can be used in epidemiological studies and disease modification trials.
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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.