Harvey-Bradshaw Index - Measuring Crohn’s Disease

The Harvey-Bradshaw Index (HBI) is a useful tool for assessing the degree of illness (activity) in patient's with Crohn's disease. The index is less cumbersome to use than the CDAI and eliminates the use of the diary card (patient pre-assessment) and laboratory monitoring. The HBI has been found to be quite useful in the management of this disease including periodic assessments of response rates to individual treatments and the assessment of the long term progress.¹

Correlating this simple index to the CDAI has shown that the HBI is more than adequate at generating an index that closely approximates disease severity based on a relatively short list of clinical criteria. Further, there appears to be no need to average symptoms out over a period of seven days or to use weighting factors.¹

General well-being: subjectively assessed - 0 (generally well), 1= slightly under par, 2=poor, 3=very poor, 4 =terrible.

Abdominal pain (graded from 0-3 on severity) (for the previous day). 0=none, 1=mild, 2=moderate, 3=severe.

Number of liquid or soft stools - previous day:

Abdominal mass - (0 = none, 1 = dubious, 2 = definite, 3 = definite and tender)

Complications (score 1 per item):
(Check all that apply)

Joint pain (arthralgia)

Inflammation of the middle layer of the eye (uveitis)

Erythema nodosum

Aphthous ulcers

Pyoderma gangrenosum

Anal fissure

New fistula

Abscess

Background Info

Scoring:

A. General well being (0=very well, l=slightly below par, 2=poor, 3=very poor, 4=terrible).
(Previous day)

B. Abdominal pain (0=none, 1=mild, 2=moderate, 3=severe).
(Previous day)

C. Number of liquid stools per day.
(Previous day)

D. Abdominal mass (0=none, l=dubious, 2=definite, 3=definite and tender).

E. Complications: arthralgia, uveitis, erythema nodosum, aphthous ulcers, pyoderma gangrenosum, anal fissure, new fistula, abscess (score 1 per item).

Measuring Crohn’s Disease - Harvey-Bradshaw Index. Gastrointestinal Society 2018. https://www.badgut.org/information-centre/a-z-digestive-topics/assessing-ibd/
Accessed: January 2019.

Interpretation:

Remission: <5
Mild Disease: 5 to 7
Moderate Disease: 8 to 16
Severe Disease: >16

References

1. Harvey RF, Bradshaw JM. A simple index of Crohn’s-disease activity. Lancet. 1980 Mar 8;1(8167):514.

Gastroenterology and related calculators

Gastrointestinal Diseases- an overview

Calculators / Tools

ABIC score – Stratification of risk of death in alcoholic hepatitis (AH)
Alcoholic Hepatitis Histological Score (AHHS)- Prognostic Stratification of Alcoholic Hepatitis
Child-Turcotte-Pugh Score -chronic liver disease - used to assess the prognosis of chronic liver disease, mainly cirrhosis. Although it was originally used to predict mortality during surgery, it is now used to determine the prognosis, as well as the required strength of treatment and the necessity of liver transplantation.
Crohn's Disease Activity Index (CDAI)- The CDAI is an important research tool for quantifying symptoms as well as determining the impact of drug therapy on overall symptoms.
Forrest classification - Risk stratification of upper gastrointestinal hemorrhage -UGIB
Glasgow alcoholic hepatitis score (GAHS) predicts survival from alcoholic hepatitis with respect to individual Glasgow alcoholic hepatitis score (GAHS) values
Glasgow-Blatchford bleeding score (GBS)- Screening tool for acute upper gastrointestinal bleeding (UGIB)
Harvey-Bradshaw Index - useful tool for assessing the degree of illness (activity) in patient's with Crohn's disease
Irritable Bowel Syndrome (IBS) treatment options
Lille Model Scoring in Severe Alcoholic Hepatitis - helps to identify patients 'early' with severe alcoholic hepatitis that are likely to respond to steroid therapy or who will require alternative treatment options.
Mayo Scoring System for Assessment of Ulcerative Colitis
MELD Score (Model For End-Stage Liver Disease) - useful tool in predicting the probability of death from liver disease and how urgently an individual needs a liver transplant in the next three months.
MELD-Na Score (Model For End-Stage Liver Disease) -United Network for Organ Sharing proposed that MELD-Na score (an extension of MELD) may better rank candidates based on their risk of pre-transplant mortality and is projected to save 50-60 lives total per year.
Modified Maddrey's discriminant function (mDF) - (Score) is a predictive statistical model useful for evaluating the severity and prognosis in alcoholic hepatitis
Ransons Criteria mortality risk for acute pancreatitis- clinical prediction rule for predicting the prognosis and mortality risk of acute pancreatitis.
Rockall score for the evaluation of upper gastrointestinal bleeding - based on clinical criteria including age, shock and presence of other comorbidities. The scoring system helps evaluate patients at risk of re-bleeding or death following acute upper gastrointestinal bleeding
Rome iii criteria for IBS
Rome IV diagnostic criteria -Irritable Bowel Syndrome
Stool Osmotic Gap- Secretory vs Osmotic diarrhea