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1.
Am J Gastroenterol ; 118(4): 748-751, 2023 04 01.
Article in English | MEDLINE | ID: mdl-36623171

ABSTRACT

To characterize the associations between clinical disease activity with endoscopic and histologic (endohistologic) mucosal healing in Crohn's disease, we performed a secondary analysis of prospectively collected data on 424 ileocolonoscopies from 258 unique adults at a tertiary referral center from 2014 to 2021. One-third of patients (34%, 25/73) in endoscopic-histologic remission reported gastrointestinal symptoms. The 2-item patient-reported outcome measure for abdominal pain and stool frequency correlated weakly with endoscopic (Simple Endoscopic Score for Crohn's Disease; r = 0.17, 95% CI 0.08-0.26, P = 0.0003) and histologic disease activity (Global Histologic Disease Activity Score; r = 0.14, 95% CI 0.03-0.24, P = 0.015). Overall, gastrointestinal symptoms correlate poorly with endohistologic disease activity.


Subject(s)
Crohn Disease , Adult , Humans , Crohn Disease/complications , Crohn Disease/pathology , Prevalence , Endoscopy, Gastrointestinal , Intestinal Mucosa/diagnostic imaging , Intestinal Mucosa/pathology , Abdominal Pain/etiology , Abdominal Pain/pathology
2.
Rev. panam. salud pública ; 34(1): 60-67, Jul. 2013. ilus, tab
Article in Spanish | LILACS | ID: lil-684695

ABSTRACT

Existe un imperativo mundial de abordar las desigualdades sanitarias a nivel nacional e internacional, definidas como diferencias en la salud injustas y evitables. Un paso hacia lograr esta meta es mejorar la base de evidencia científica rigurosa relacionada con las repercusiones de las políticas sobre las desigualdades en los resultados de la salud, la asignación de recursos y su uso. Las revisiones sistemáticas son cada vez más reconocidas como fuente de evidencia valiosa para la toma de decisiones relacionadas con la atención sanitaria y los sistemas sanitarios; sin embargo, muy pocas revisiones sistemáticas informan acerca de los efectos sobre la equidad en salud. Desarrollamos guías consensuadas para la escritura y publicación de revisiones sistemáticas centradas en la equidad, para ayudar a que los revisores identifiquen, extraigan y sinteticen la evidencia sobre la equidad en las revisiones sistemáticas. El uso cada vez mayor de estas guías para escribir y publicar trabajos científicos ayudará a mejorar los informes de los efectos sobre las desigualdades en los resultados de la salud y el uso de la atención sanitaria según el género, la posición socioeconómica y otras características, tanto en las revisiones sistemáticas como, en última instancia, en la investigación primaria, y en consecuencia contribuirá a la agenda mundial para optimizar la equidad en salud.


There is a global imperative to tackle national and international health inequities- defined as unfair and avoidable differences in health. One step in reaching this goal is to improve the rigorous, scientific evidence base on the impacts of policies on inequities in health outcomes, resource allocation, and use. Systematic reviews are increasingly recognized as a valuable source of evidence for both health care and health systems decision making, yet very few systematic reviews report effects on health equity. We developed consensus-based reporting guidelines for equity-focused systematic reviews in order to help reviewers identify, extract, and synthesise evidence on equity in systematic reviews. Increased use of these reporting guidelines will help improve the reporting of effects on both inequities in health outcomes and health care use across gender, socioeconomic position, and other characteristics, both in systematic reviews and eventually primary research, thus contributing to the global agenda to improve health equity.


Subject(s)
Review , Health Equity/organization & administration , Health Equity
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