Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

    Disease

    Select...

    Specialty

    Select...

    Chief Complaint

    Select...

    Organ System

    Select...

    Patent Pending

    Mayo Score / Disease Activity Index (DAI) for Ulcerative Colitis

    Assesses severity of ulcerative colitis.
    When to Use
    Pearls/Pitfalls
    Why Use
    • Patients with known ulcerative colitis, particularly when considering changing, adding, or stopping a UC medication; this is not a tool to diagnose ulcerative colitis.
    • The Mayo Score is the most commonly used scoring system for UC in clinical trials and routine practice (Paine 2014).
    • The Mayo Score for Ulcerative Colitis was developed to standardize the severity of a patient's ulcerative colitis (UC) symptoms, which is particularly helpful to assess response to treatment over time.
    • The Mayo Score for Ulcerative Colitis was originally devised in 1987 for a clinical trial for pH dependent 5-ASA (Asacol) at the Mayo Clinic.
    • Comprised of 4 parts: stool frequency, rectal bleeding, endoscopic findings and physician’s global assessment, each scored from 0-3.
    • The physician’s global assessment accounts for other signs/symptoms including abdominal pain, physical exam findings (extraintestinal manifestations, fever, tachycardia), functional status, and the patient’s overall sense of well being.
    • Total scores range from 0-12 with higher scores indicating increased severity of disease.
    • Response to therapy is defined differently in each trial, but most use a decrease of 3 or more points.
      • Remission is often defined as a total score of 2 or less with all individual categories ≤1. Occasionally, remission is defined stringently as a score of 0.
      • Most clinical trials define mucosal healing as an endoscopic score of 0 or 1, although numerous other endoscopic scoring systems exist (D’Haens 20074).
    • The “Full” or “Complete” Mayo score incorporates all 4 parts.
    • If endoscopic findings are not available, the remaining 3 categories constitute a “Modified” or “Partial” Mayo score.

    Points to keep in mind:

    • For stool frequency and rectal bleeding, the patient acts as their own point of reference (i.e. number of stools above normal) rather than the absolute number.
    • Critics point out an element of subjectivity in the Physician’s Global Assessment (sense of well being).
    • The score is not designed to predict need for admission or surgical therapy.
    • This is not a tool to diagnose ulcerative colitis, rather a tool to evaluate patients with known UC.
    • Assesses initial disease severity, change in activity over time, and response to treatment.
    • Provides a universal metric to encapsulate disease severity at a given time in a single number.

    Similar calcs:

    • Nearly identical to the UC Disease Activity Index (DAI) devised by Sutherland et al. Both scores were released in 1987 as objective measures to examine the effects of salicylates in UC. Both rely on the same 4 categories but have miniscule differences in their point assignments
    Normal
    0
    1-2 stools/day more than normal
    +1
    3-4 stools/day more than normal
    +2
    >4 stools/day more than normal
    +3
    None
    0
    Visible blood with stool less than half the time
    +1
    Visible blood with stool half of the time or more
    +2
    Passing blood alone
    +3
    Normal or inactive disease
    0
    Mild disease (erythema, decreased vascular pattern, mild friability)
    +1
    Moderate disease (marked erythema, absent vascular pattern, friability, erosions)
    +2
    Severe disease (spontaneous bleeding, ulceration)
    +3
    Normal
    0
    Mild
    +1
    Moderate
    +2
    Severe
    +3

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights
    Dr. Kenneth W. Schroeder

    About the Creator

    Kenneth W. Schroeder, MD, is an associate professor of medicine, specifically in gastroenterology and hepatology the Mayo Clinic. Dr. Schroeder researches endoscopic diagnosis/treatment of GI diseases and inflammatory bowel disease.

    To view Dr. Kenneth W. Schroeder's publications, visit PubMed

    Are you Dr. Kenneth W. Schroeder? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Content Contributors
    About the Creator
    Dr. Kenneth W. Schroeder
    Are you Dr. Kenneth W. Schroeder?
    Content Contributors