PLoS ONE (Jan 2020)

Validation of models using basic parameters to differentiate intestinal tuberculosis from Crohn's disease: A multicenter study from Asia.

  • 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

DOI
https://doi.org/10.1371/journal.pone.0242879
Journal volume & issue
Vol. 15, no. 11
p. e0242879

Abstract

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BackgroundData 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.MethodsData 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.ResultsFive 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, pConclusionsScoring 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.