cliot (version 1.0.0)

isee_eoe_severity_index: Index of Severity for Eosinophilic Esophagitis (I-SEE)

Description

Calculates the I-SEE score to assess the severity of Eosinophilic Esophagitis (EoE). The score categorizes disease activity into Inactive, Mild, Moderate, or Severe based on symptoms, complications, and inflammatory/fibrostenotic features found on endoscopy and histology.

Usage

isee_eoe_severity_index(symptoms_frequency,
food_impaction_code, hospitalization_eoe,
esophageal_perforation, malnutrition_code,
persistent_inflammation,
 endoscopic_inflammatory_grade,
 peak_eosinophil_count_grade,
 endoscopic_fibrostenotic_grade,
 histologic_fibrostenotic_grade)

Value

A list containing:

ISEE_Score

The calculated total severity score.

Severity

Classification (Inactive <1, Mild 1-6, Moderate 7-14, Severe >=15).

Arguments

symptoms_frequency

Numeric. Frequency of symptoms (Dysphagia, Pain, etc.). 0: None. 1: Weekly. 2: Daily. 3: Multiple times per day or disrupting social functioning.

food_impaction_code

Numeric. History of food impaction requiring ER visit or endoscopy. 0: None. 1: Food impaction in adult (>=18 years). 2: Food impaction in child (<18 years).

hospitalization_eoe

Numeric (0 or 1). Hospitalization due to EoE (excluding planned elective procedures). (1 = Yes, +4 points).

esophageal_perforation

Numeric (0 or 1). History of esophageal perforation. (1 = Yes, +15 points).

malnutrition_code

Numeric (0 or 1). Malnutrition (BMI <5th percentile or decreased growth trajectory). (1 = Yes, +15 points).

persistent_inflammation

Numeric (0 or 1). Persistent inflammation requiring elemental formula, systemic steroids, or biologics. (1 = Yes, +15 points).

endoscopic_inflammatory_grade

Numeric. Endoscopic inflammatory features (Edema, Furrows, Exudates). 0: None. 1: Localized. 2: Diffuse.

peak_eosinophil_count_grade

Numeric. Peak Eosinophil Count (eos/hpf). 0: < 15. 1: 15-60. 2: > 60.

endoscopic_fibrostenotic_grade

Numeric. Endoscopic fibrostenotic features (Rings, Strictures). 0: None. 1: Present, endoscope passes easily. 2: Present, requires dilation or snug fit. 3: Cannot pass standard scope, repeated dilations (adult), or any dilation (child). (+15 points).

histologic_fibrostenotic_grade

Numeric (0 or 1). Histologic fibrostenotic features (Basal zone hyperplasia, lamina propria fibrosis). (1 = Yes, +2 points).

References

Dellon ES, Khoury P, Muir AB, et al. A Clinical Severity Index for Eosinophilic Esophagitis: Development, Consensus, and Future Directions. Gastroenterology. 2022;163(1):59-76. doi:10.1053/j.gastro.2022.03.025

Examples

# Example 1: Moderate EoE
# Daily symptoms(2), Localized inflam(1), Eos 40(1), BZH(2)
# Score = 2 + 1 + 1 + 2 = 6 (Wait, 6 is Mild? Check logic. Mild 1-6. So Mild/Moderate border.)
isee_eoe_severity_index(2, 0, 0, 0, 0, 0, 1, 1, 0, 1)

# Example 2: Severe EoE
# Stricture requiring dilation (+15), Daily Sx (+2)
# Score = 17
isee_eoe_severity_index(2, 0, 0, 0, 0, 0, 1, 1, 3, 0)