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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


Background Info


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.
Accessed: January 2019.

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


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

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