Alimentary Pharmacology & Therapeutics | 2021
Editorial: use of intestinal ultrasound in the scoring of Crohn’s disease activity in clinical trials – is it ready for prime time yet? Authors’ reply
Abstract
We appreciate the very thoughtful editorial on the current state of intestinal ultrasound (IUS) by Abushamma and Deepak.1 We agree that rigorous evaluation of interand intrarater reliability is limited and IUS is not yet immediately applicable to Crohn’s disease clinical trials in the absence of a standardised activity scoring index. Disease assessment for Crohn’s disease has no single gold standard test or ‘truth’. Endoscopic assessment is limited by the reach of the colonoscope, dependent on proceduralist skill and cannot evaluate transmural or indeed extramural disease activity. Similarly, histological assessment is limited by sampling error and lack of a validated histological activity index, magnetic resonance enterography is dependent on imaging quality and reader expertise and biomarkers are dependent on disease distribution with intrasample variability.25