Development of a Novel Predictive Model for the Clinical Course of Crohn's Disease: Results from the CONNECT Study

Yehyun Park, Jae Hee Cheon, Yi Lang Park, Byong Duk Ye, You Sun Kim, Dong Soo Han, Joo Sung Kim, Sung Noh Hong, Young Ho Kim, Seong Ran Jeon, Won Ho Kim

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: A considerable number of patients with Crohn's disease (CD) develop irreversible intestinal damage, although the early administration of immunomodulatory or biological therapies might prevent this. The aims of our study were to develop and validate a novel predictive model that can be used to predict the risk of surgical intervention in Korean patients with CD. Methods: The prognostic model was derived from the multicenter longitudinal CONNECT (CrOhn's disease cliNical NEtwork and CohorT) study cohort consisting of 1338 patients with CD, who were split into training and validation sets. The Korean Crohn's Disease Prediction (KCDP) model was developed with the training set data using the Cox proportional hazards model and multivariate analysis, and was then validated using the validation set. Results: A total of 1271 patients with CD were analyzed. During the follow-up period of 10,188 patient-years (median 7.1 yrs), 361 patients (28.4%) underwent CD-related surgery. Age at diagnosis, jejunal involvement, initial disease behavior, and perianal disease at diagnosis were associated with a poor prognosis and included in the KCDP model, which showed a modest discrimination ability with a Harrel's c-index of 0.731 at 5 years, and was well calibrated (Hosmer-Lemeshow χ 2 = 8.230, P = 0.511). Conclusions: This is the first validated surgery risk prediction model for Korean patients with CD; it provides accurate individualized estimates of the probability of surgery using clinical parameters collected at diagnosis. This model might guide appropriate patient selection for the early intensive treatment of CD.

Original languageEnglish
Pages (from-to)1071-1079
Number of pages9
JournalInflammatory Bowel Diseases
Volume23
Issue number7
DOIs
Publication statusPublished - 2017 Jul 1

Fingerprint

Crohn Disease
Cohort Studies
Clinical Studies
Biological Therapy
Immunomodulation
Proportional Hazards Models
Patient Selection
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Gastroenterology

Cite this

Park, Yehyun ; Cheon, Jae Hee ; Park, Yi Lang ; Ye, Byong Duk ; Kim, You Sun ; Han, Dong Soo ; Kim, Joo Sung ; Hong, Sung Noh ; Kim, Young Ho ; Jeon, Seong Ran ; Kim, Won Ho. / Development of a Novel Predictive Model for the Clinical Course of Crohn's Disease : Results from the CONNECT Study. In: Inflammatory Bowel Diseases. 2017 ; Vol. 23, No. 7. pp. 1071-1079.
@article{eca9ab6ace1a4dcda277a8093271500e,
title = "Development of a Novel Predictive Model for the Clinical Course of Crohn's Disease: Results from the CONNECT Study",
abstract = "Background: A considerable number of patients with Crohn's disease (CD) develop irreversible intestinal damage, although the early administration of immunomodulatory or biological therapies might prevent this. The aims of our study were to develop and validate a novel predictive model that can be used to predict the risk of surgical intervention in Korean patients with CD. Methods: The prognostic model was derived from the multicenter longitudinal CONNECT (CrOhn's disease cliNical NEtwork and CohorT) study cohort consisting of 1338 patients with CD, who were split into training and validation sets. The Korean Crohn's Disease Prediction (KCDP) model was developed with the training set data using the Cox proportional hazards model and multivariate analysis, and was then validated using the validation set. Results: A total of 1271 patients with CD were analyzed. During the follow-up period of 10,188 patient-years (median 7.1 yrs), 361 patients (28.4{\%}) underwent CD-related surgery. Age at diagnosis, jejunal involvement, initial disease behavior, and perianal disease at diagnosis were associated with a poor prognosis and included in the KCDP model, which showed a modest discrimination ability with a Harrel's c-index of 0.731 at 5 years, and was well calibrated (Hosmer-Lemeshow χ 2 = 8.230, P = 0.511). Conclusions: This is the first validated surgery risk prediction model for Korean patients with CD; it provides accurate individualized estimates of the probability of surgery using clinical parameters collected at diagnosis. This model might guide appropriate patient selection for the early intensive treatment of CD.",
author = "Yehyun Park and Cheon, {Jae Hee} and Park, {Yi Lang} and Ye, {Byong Duk} and Kim, {You Sun} and Han, {Dong Soo} and Kim, {Joo Sung} and Hong, {Sung Noh} and Kim, {Young Ho} and Jeon, {Seong Ran} and Kim, {Won Ho}",
year = "2017",
month = "7",
day = "1",
doi = "10.1097/MIB.0000000000001106",
language = "English",
volume = "23",
pages = "1071--1079",
journal = "Inflammatory Bowel Diseases",
issn = "1078-0998",
publisher = "John Wiley and Sons Inc.",
number = "7",

}

Park, Y, Cheon, JH, Park, YL, Ye, BD, Kim, YS, Han, DS, Kim, JS, Hong, SN, Kim, YH, Jeon, SR & Kim, WH 2017, 'Development of a Novel Predictive Model for the Clinical Course of Crohn's Disease: Results from the CONNECT Study', Inflammatory Bowel Diseases, vol. 23, no. 7, pp. 1071-1079. https://doi.org/10.1097/MIB.0000000000001106

Development of a Novel Predictive Model for the Clinical Course of Crohn's Disease : Results from the CONNECT Study. / Park, Yehyun; Cheon, Jae Hee; Park, Yi Lang; Ye, Byong Duk; Kim, You Sun; Han, Dong Soo; Kim, Joo Sung; Hong, Sung Noh; Kim, Young Ho; Jeon, Seong Ran; Kim, Won Ho.

In: Inflammatory Bowel Diseases, Vol. 23, No. 7, 01.07.2017, p. 1071-1079.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Development of a Novel Predictive Model for the Clinical Course of Crohn's Disease

T2 - Results from the CONNECT Study

AU - Park, Yehyun

AU - Cheon, Jae Hee

AU - Park, Yi Lang

AU - Ye, Byong Duk

AU - Kim, You Sun

AU - Han, Dong Soo

AU - Kim, Joo Sung

AU - Hong, Sung Noh

AU - Kim, Young Ho

AU - Jeon, Seong Ran

AU - Kim, Won Ho

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Background: A considerable number of patients with Crohn's disease (CD) develop irreversible intestinal damage, although the early administration of immunomodulatory or biological therapies might prevent this. The aims of our study were to develop and validate a novel predictive model that can be used to predict the risk of surgical intervention in Korean patients with CD. Methods: The prognostic model was derived from the multicenter longitudinal CONNECT (CrOhn's disease cliNical NEtwork and CohorT) study cohort consisting of 1338 patients with CD, who were split into training and validation sets. The Korean Crohn's Disease Prediction (KCDP) model was developed with the training set data using the Cox proportional hazards model and multivariate analysis, and was then validated using the validation set. Results: A total of 1271 patients with CD were analyzed. During the follow-up period of 10,188 patient-years (median 7.1 yrs), 361 patients (28.4%) underwent CD-related surgery. Age at diagnosis, jejunal involvement, initial disease behavior, and perianal disease at diagnosis were associated with a poor prognosis and included in the KCDP model, which showed a modest discrimination ability with a Harrel's c-index of 0.731 at 5 years, and was well calibrated (Hosmer-Lemeshow χ 2 = 8.230, P = 0.511). Conclusions: This is the first validated surgery risk prediction model for Korean patients with CD; it provides accurate individualized estimates of the probability of surgery using clinical parameters collected at diagnosis. This model might guide appropriate patient selection for the early intensive treatment of CD.

AB - Background: A considerable number of patients with Crohn's disease (CD) develop irreversible intestinal damage, although the early administration of immunomodulatory or biological therapies might prevent this. The aims of our study were to develop and validate a novel predictive model that can be used to predict the risk of surgical intervention in Korean patients with CD. Methods: The prognostic model was derived from the multicenter longitudinal CONNECT (CrOhn's disease cliNical NEtwork and CohorT) study cohort consisting of 1338 patients with CD, who were split into training and validation sets. The Korean Crohn's Disease Prediction (KCDP) model was developed with the training set data using the Cox proportional hazards model and multivariate analysis, and was then validated using the validation set. Results: A total of 1271 patients with CD were analyzed. During the follow-up period of 10,188 patient-years (median 7.1 yrs), 361 patients (28.4%) underwent CD-related surgery. Age at diagnosis, jejunal involvement, initial disease behavior, and perianal disease at diagnosis were associated with a poor prognosis and included in the KCDP model, which showed a modest discrimination ability with a Harrel's c-index of 0.731 at 5 years, and was well calibrated (Hosmer-Lemeshow χ 2 = 8.230, P = 0.511). Conclusions: This is the first validated surgery risk prediction model for Korean patients with CD; it provides accurate individualized estimates of the probability of surgery using clinical parameters collected at diagnosis. This model might guide appropriate patient selection for the early intensive treatment of CD.

UR - http://www.scopus.com/inward/record.url?scp=85021260234&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021260234&partnerID=8YFLogxK

U2 - 10.1097/MIB.0000000000001106

DO - 10.1097/MIB.0000000000001106

M3 - Article

C2 - 28410345

AN - SCOPUS:85021260234

VL - 23

SP - 1071

EP - 1079

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 7

ER -