cliot (version 1.0.0)

irae_colitis_grading: irAE Grading for Colitis (GI Toxicities)

Description

Calculates the CTCAE severity grade for colitis associated with immune checkpoint inhibitor (ICPi) therapy. Grading is based on the increase in stool frequency over baseline, presence of incontinence, severity of symptoms (pain, blood, mucus), and life-threatening complications (e.g., perforation).

[Image of bristol stool scale chart]

Usage

irae_colitis_grading(stools_above_baseline, incontinence, life_threatening,
                     pain_mucus_blood)

Value

A list containing:

CTCAE_Grade

The calculated adverse event grade (1-4).

Definition

Clinical description of the grade.

Management_Recommendation

Guidance on ICPi continuation and immunosuppressive therapy based on ASCO guidelines.

Arguments

stools_above_baseline

Numeric. Number of stools per day ABOVE the patient's baseline. (<4: Grade 1, 4-6: Grade 2, >=7: Grade 3).

incontinence

Numeric (0 or 1). New onset of incontinence? (1 = Yes). Presence indicates at least Grade 3.

life_threatening

Numeric (0 or 1). Are there life-threatening consequences (e.g., perforation, shock)? (1 = Yes). Indicates Grade 4.

pain_mucus_blood

Numeric (0 or 1). Presence of severe abdominal pain, mucus, or blood in stool? (1 = Yes). Often associated with Grade 3 severity in clinical context/guidelines if impacting ADL, though pure stool count is primary driver.

References

Brahmer JR, Lacchetti C, Schneider BJ, et al. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2018;36(17):1714-1768. doi:10.1200/JCO.2017.77.6385

Examples

# Example 1: Grade 3 Colitis
# 8 stools over baseline, no life threatening signs
irae_colitis_grading(8, 0, 0, 0)

# Example 2: Grade 2 Colitis
# 5 stools over baseline
irae_colitis_grading(5, 0, 0, 0)