The American Gastroenterologial Association (AGA) recently created a clinical decision tool to help gastroenterologists both identify and manage Crohn’s disease in their patients. “Identification, Assessment, and Initial Medical Treatment in Crohn’s Disease Clinical Decision Support Tool” is the result of expert work, using an algorithm with the purpose of unifying the treatment for the heterogeneous disease, which was recently published in the official journal of the AGA, Gastroenterology.
“As health care systems move toward providing better quality care, it is important for gastroenterologists to have clinical support tools that will help them treat underlying disease, as well as the whole person,” explained one the author of the clinical decision tool, William J. Sandborn, MD, from the division of gastroenterology, of the Inflammatory Bowel Disease Center, at the University of California, San Diego. “This clinical support tool represents a big step forward for the treatment of Crohn’s disease and was created using a rigorous review process.”
The group of researchers working on the clinical decision tool started by reviewing the latest data on the disease in order to create the algorithm to support physicians in evaluating their patients for active inflammation and comorbidities, as well as risk-stratification and application of appropriate therapies. The researchers based their work mainly on the AGA document “Guideline on the Use of Thiopurines, Methotrexate, and Anti-TNF-a Biologic Drugs for the Induction and Maintenance of Remission in Inflammatory Crohn’s Disease.”
“With the well-justified push toward providing better value in health care, we will ultimately need to have clinical support tools that focus on treating the underlying disease as well as the whole person, quality improvement programs that focus on reducing practice variations related to these clinical support tools, and cost utility analyses to help us better select therapies that provide value to patients and to society,” believes Sandborn.
The physician explained that Crohn’s disease is an heterogeneous disease, which means that it has several different presentations; clinical courses; inflammatory, structuring or fistulizing disease states; and therapy options, which is why it is so difficult to have a standard clinical decision support tool based on a series of algorithms. The researchers aimed to create an algorithm able to evaluate and treat the majority of CD patients. The document particularly recommends the use anti-TNF agents as an effective means of treatment.
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