Symptoms Have Modest Accuracy in Detecting Endoscopic and Histologic Remission in Adults With XXXX .

@entity1 @entity4 @entity5202
BACKGROUND _ AIMS: It is not clear whether symptoms alone can be used to estimate the biologic activity of @entity5202 ( @entity5202 ). We aimed to evaluate whether symptoms can be used to identify @entity1 with endoscopic and histologic features of remission. METHODS: Between April 2011 and June 2014, we performed a prospective, observational study and recruited 269 consecutive adults with @entity5202 (67% male; median age, 39 years old) in Switzerland and the United States. @entity1 first completed the validated symptom-based @entity5202 activity index @entity1 -reported outcome instrument and then underwent esophagogastroduodenoscopy with esophageal biopsy collection. Endoscopic and histologic findings were evaluated with a validated grading system and standardized instrument, respectively. Clinical remission was defined as symptom score <20 (range, 0-100); histologic remission was defined as a peak count of <20 eosinophils/mm(2) in a high-power field (corresponds to approximately <5 eosinophils/median high-power field); and endoscopic remission as absence of white exudates, moderate or severe rings, strictures, or combination of furrows and @entity4 . We used receiver operating characteristic analysis to determine the best symptom score cutoff values for detection of remission. RESULTS: Of the study subjects, 111 were in clinical remission (41.3%), 79 were in endoscopic remission (29.7%), and 75 were in histologic remission (27.9%). When the symptom score was used as a continuous variable, @entity1 in endoscopic, histologic, and combined (endoscopic and histologic remission) remission were detected with area under the curve values of 0.67, 0.60, and 0.67, respectively. A symptom score of 20 identified @entity1 in endoscopic remission with 65.1% accuracy and histologic remission with 62.1% accuracy; a symptom score of 15 identified @entity1 with both types of remission with 67.7% accuracy. CONCLUSIONS: In @entity1 with @entity5202 , endoscopic or histologic remission can be identified with only modest accuracy based on symptoms alone. At any given time, physicians cannot rely on lack of symptoms to make assumptions about lack of biologic disease activity in adults with @entity5202 . ClinicalTrials.gov, Number: NCT00939263.
