cliot (version 1.0.0)

truelove_witts_severity_index: Truelove and Witts Severity Index for Ulcerative Colitis

Description

Calculates the Truelove and Witts Severity Index to classify the severity of an Ulcerative Colitis flare. The classification is based on six criteria: stool frequency, rectal bleeding, temperature, pulse, hemoglobin, and ESR.

Usage

truelove_witts_severity_index(bowel_movements_per_day, rectal_bleeding,
                              temperature_c, heart_rate, hemoglobin_g_dl, esr)

Value

A list containing:

Severity_Index

The severity classification (Mild, Moderate, Severe).

Arguments

bowel_movements_per_day

Numeric. Number of bowel movements per day.

rectal_bleeding

String. Presence of blood in stool. Options: "none" (small/none), "intermittent", "frequent_continuous" (visible blood).

temperature_c

Numeric. Body temperature in degrees Celsius. (> 37.5 C is a severe criterion).

heart_rate

Numeric. Pulse rate in beats per minute. (> 90 bpm is a severe criterion).

hemoglobin_g_dl

Numeric. Hemoglobin level in g/dL. (<= 10.5 g/dL is a severe criterion).

esr

Numeric. Erythrocyte Sedimentation Rate in mm/hr. (> 30 mm/hr is a severe criterion).

Details

Classification logic: - **Severe**: >= 6 bloody stools/day AND at least one sign of systemic toxicity (Temp > 37.5, HR > 90, Hgb <= 10.5, or ESR > 30). - **Mild**: < 4 stools/day, with no or intermittent bleeding, and normal vital signs/labs. - **Moderate**: Intermediate between Mild and Severe (e.g., > 4 stools but not meeting severe criteria).

References

Truelove SC, Witts LJ. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955;2(4947):1041-1048. doi:10.1136/bmj.2.4947.1041

Examples

# Example 1: Severe Colitis
# 8 stools, frequent blood, HR 100, Temp 38
truelove_witts_severity_index(8, "frequent_continuous", 38.0, 100, 11.0, 25)

# Example 2: Mild Colitis
# 3 stools, intermittent blood, normal vitals/labs
truelove_witts_severity_index(3, "intermittent", 37.0, 70, 14.0, 10)