A0357 - Use of IBD Endoscopic Scoring Systems in Practice

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

JG

Jill K. Gaidos, MD

Yale University School of Medicine
New Haven, CT

Jill K. Gaidos, MD¹, Badr Al-Bawardy, MD¹, Francis A. Farraye, MD, MSc², Miguel Regueiro, MD³
¹Yale University School of Medicine, New Haven, CT; ²Mayo Clinic, Jacksonville, FL; ³Cleveland Clinic, Cleveland, OH

Introduction: Inflammatory bowel disease (IBD) treatment targets include mucosal healing based on standardized endoscopic scoring systems. The rates and ease of use of these scoring systems in practice have not been well described. We aimed to assess the rates and potential barriers to using IBD endoscopic scoring systems in practice from IBD Live attendees.

Methods: IBD LIVE is an international case-based conference focusing on the management of patients with IBD. We created a web-based survey consisting of 38 questions on the frequency and ease of use of various IBD endoscopic scores. This survey was emailed to the IBD LIVE listserv in March 2022 with a second email sent 14 days later. We included only respondents who are currently performing endoscopy. Continuous variables were analyzed using an unpaired student’s t-test. Categorical variables were analyzed using a Pearson’s chi-square test.

Results: There were 65 responses out of 170 (38.2% response rate) regular attendees. Eleven responses were excluded (4 with no response on the use of endoscopy scores, 7 were not performing endoscopy). Of the respondents, 72.2% are from the US, 70.4% are adult gastroenterologists, 53.9% in academic practice, and 40.7% in practice for ≥ 15 years. Of the endoscopy scores used ≥ 50% of the time, 74.1% were using the Mayo Endoscopic Sub-score (MES), 72.3% using the Rutgeert's Score, 61.2% using the Simple Endoscopic Score for Crohn's Disease, and 28.6% using the Pouchitis Disease Activity Index. Attending IBD Live ≥ monthly (p=0.028), attending an IBD conference ≥ every 2 years (p=0.020), and having the scoring system incorporated into the endoscopy documentation software (p=0.002) were associated with more consistent use of the MES. Attending IBD Live ≥ monthly (p=0.026), having an IBD volume of ≥ 50% (p=0.011), and attending an IBD conference ≥ every 2 years (p=0.004) was associated with more frequent use of the Rutgeert’s score. There were no factors that increased the use of other endoscopic scores.

Discussion: The MES and the Rutgeert’s score are more commonly used with much lower rates of use of endoscopic scores for Crohn’s disease and pouchitis. The use of these endoscopy scores is more common among those who regularly attend IBD conferences, have higher volume IBD practices and have these scoring systems incorporated into endoscopy software. Further evaluation of ways to improve utilization of endoscopic scoring for Crohn’s disease and pouchitis are needed.

Use of Mayo UC Endoscopic Subscore	≥50% of the time (n=40), n (%)	< 50% of the time (n=14), n (%)	p-value
Endoscopic Score Built into Software	27 (67.5)	3 (21.4)	0.002
Attend IBD Conference ≥ every 2 Years	39 (97.5)	11 (78.6)	0.020
Attend IBD Live: At least monthly Less than monthly	30 (75) 10 (25)	6 (42.9) 8 (57.1)	0.028
Number of years in GI Practice: < 10 years ≥ 10 years	18 (45) 22 (55)	5 (35.7) 9 (64.3)	0.55
Specialty: Adult GI Pediatric GI Colorectal Surgery Other	32(84.2) 4 (80) 4 (80) 0	6(15.8) 1(20) 6(60) 1(100)	0.012
Use of the Rutgeert's Score	≥50% of the time (n=34), n (%)	< 50% of the time (n=13), n (%)	p-value
Endoscopic Score Built into Software	17 (50)	3 (23.1)	0.45
Attend IBD Conference ≥ Every 2 Years	34 (100)	10 (76.9)	0.004
IBD patient volume ≥50%	22 (64.7)	3 (23.1)	0.011
Attend IBD Live: At least monthly Less than monthly	23(76.7) 7(23.3)	6(46.2) 7(53.8)	0.026
Number of years in GI Practice: < 10 years ≥ 10 years	14(41.2) 20(58.8)	4(30.8) 9(69.2)	0.51
Specialty: Adult GI Pediatric GI Colorectal Surgery	27 (79.4) 3(8.8) 4(11.8)	7(53.9) 2(15.4) 4(30.8)	0.19
Use of Simple Endoscopic Score for Crohn's Disease	≥50% of the time (n=30), n (%)	< 50% of the time (n=19), n (%)	p-value
Endoscopic Score Built into Software	18 (60)	6 (31.6)	0.09
Attend IBD Conference ≥ Every 2 Years	29 (96.7)	16 (84.2)	0.12
IBD patient volume ≥50%	17 (56.7)	8 (42.1)	0.32
Attend IBD Live: At least monthly Less than monthly	23(76.7) 7(23.3)	11(57.9) 8(42.1)	0.16
Number of years in GI Practice: < 10 years ≥ 10 years	15(50) 15(50)	5(26.3) 14(73.7)	0.10
Specialty: Adult GI Pediatric GI Colorectal Surgery	24(68.6) 2(40) 4(44.4)	11(31.4) 3(60) 5(55.6)	0.25

Table: Results

Disclosures:

Jill Gaidos: AbbVie – Speakers Bureau.

Badr Al-Bawardy: AbbVie – Speakers Bureau. Bristol Myers Squibb – Advisor or Review Panel Member. Takeda – Speakers Bureau.

Francis Farraye: Adiso Therapeutics – DSMB. BMS – Advisory Committee/Board Member. Braintree Labs – Advisory Committee/Board Member. GSK – Advisory Committee/Board Member. IBD Educational Group – Advisory Committee/Board Member. Innovation Pharmaceuticals – Stock Options. Iterative Scopes – Advisory Committee/Board Member. Janssen – Advisory Committee/Board Member. Lilly – DSMB. Pfizer – Advisory Committee/Board Member. Sebela – Advisory Committee/Board Member. Theravance – DSMB.

Miguel Regueiro: Abbvie – Consultant. Bristol Meyer Squibb – Consultant. Janssen – Consultant. Lilly – Consultant. Pfizer – Consultant. Takeda – Consultant.

Jill K. Gaidos, MD¹, Badr Al-Bawardy, MD¹, Francis A. Farraye, MD, MSc², Miguel Regueiro, MD³. A0357 - Use of IBD Endoscopic Scoring Systems in Practice, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.