Ulcerative Colitis Endoscopic Index of Severity (UCEIS) Score
Evaluates the severity of UC symptoms based on vascular pattern, bleeding and erosions & ulcers.
Refer to the text below the score for more information on the three descriptors used and the result interpretation.
The Ulcerative Colitis Endoscopic Index of Severity (UCEIS) helps clinicians with the endoscopic assessment of UC disease activity.
Compared to other scores (such as the Mayo or the Baron Score) is the most validated in several research studies and has consistently shown the best correlation with clinical symptoms.
The three descriptors of the model in combination account for 88% of variance between observers and 96% of the scale of the full range of severity.
| UCEIS Score | Interpretation |
| 0 - 1 | Remission |
| 2 - 4 | Mild |
| 5 - 6 | Moderate |
| 7 - 8 | Severe |
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UCEIS Score Explained
The Ulcerative Colitis Endoscopic Index of Severity (UCEIS) is used in the endoscopic assessment of disease activity in UC and compared to other scores (such as the Mayo or the Baron Score) is the most validated in several research studies and has consistently shown the best correlation with clinical symptoms.
The table below describes each of the three items and the interpretation of their answer choices:
| UCEIS items | Answer Choices |
| Vascular pattern | Normal (1) Normal vascular pattern with arborisation of capillaries clearly defined, or with blurring or patchy loss of capillary margins |
| Patchy obliteration (2) Patchy obliteration of vascular pattern |
|
| Obliterated (3) Complete obliteration of vascular pattern |
|
| Bleeding | None (1) No visible blood |
| Mucosal (2) Some spots or streaks of coagulated blood on the surface of the mucosa ahead of the scope, which can be washed away |
|
| Luminal mild (3) Some free liquid blood in the lumen |
|
| Luminal moderate or severe (4) Frank blood in the lumen ahead of endoscope or visible oozing from mucosa after washing intra-luminal blood, or visible oozing from a haemorrhagic mucosa |
|
| Erosions & Ulcers | None (1) Normal mucosa, no visible erosions or ulcers |
| Erosions (2) Tiny (<5mm) defects in the mucosa, of a white or yellow colour with a flat edge |
|
| Superficial ulcer (3) Larger (>5mm) defects in the mucosa, which are discrete fibrin-covered ulcers when compared to erosions, but remain superficial |
|
| Deep ulcer (4) Deeper excavated defects in the mucosa, with a slightly raised edge |
The UCEIS score has so far shown good reliability (intra & inter-investigator performance) and may help with UC diagnosis, clinical trial and/or treatment decision making.
| UCEIS Score | Interpretation |
| 0 - 1 | Remission |
| 2 - 4 | Mild |
| 5 - 6 | Moderate |
| 7 - 8 | Severe |
In the original study, Travis et al. observed UC symptoms and clinical signs agreement between experienced investigators and tested kappa statistics, inter-and intra-observer variability for each descriptor (0.34-0.65 and 0.30-0.45 within and between observers for 10 descriptors), finally using general linear mixed regression modelling.
The developed model retained the three descriptors: vascular pattern, bleeding and erosions & ulcers. The three terms in combination account for 88% of variance between observers and 96% of the scale of the full range of severity.
One of the limitations of the score is reported to be the unclear differentiation between erosion and superficial ulceration.
Several studies have found that the UCEIS outperformed the other readily available UC evaluation tool, the Mayo Score Disease Activity Index.
References
Original reference
Travis SP, Schnell D, Krzeski P, Abreu MT, Altman DG, Colombel JF, Feagan BG, Hanauer SB, Lémann M, Lichtenstein GR, Marteau PR, Reinisch W, Sands BE, Yacyshyn BR, Bernhardt CA, Mary JY, Sandborn WJ. Developing an instrument to assess the endoscopic severity of ulcerative colitis: the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). Gut. 2012; 61(4):535-42.
©2013 UCEIS copyright is registered to Warner Chilcott on the principle that there is unrestricted access to the UCEIS. The UCEIS Index was developed by the UCEIS Study Group.
Validation
Travis SP, Schnell D, Krzeski P, Abreu MT, Altman DG, Colombel JF, Feagan BG, Hanauer SB, Lichtenstein GR, Marteau PR, Reinisch W, Sands BE, Yacyshyn BR, Schnell P, Bernhardt CA, Mary JY, Sandborn WJ. Reliability and initial validation of the ulcerative colitis endoscopic index of severity. Gastroenterology. 2013; 145(5):987-95.
Other references
Ikeya K, Hanai H, Sugimoto K, Osawa S, Kawasaki S, Iida T, Maruyama Y, Watanabe F. The Ulcerative Colitis Endoscopic Index of Severity More Accurately Reflects Clinical Outcomes and Long-term Prognosis than the Mayo Endoscopic Score. J Crohns Colitis. 2016; 10(3):286-95.
Bader H. et al. Baseline Ulcerative Colitis Endoscopic Index of Severity and Endoscopic Mayo Score Perform Similarly Predicting Response to Medical Therapy in Patients with Ulcerative Colitis. American Journal of Gastroenterology: October 2018 - Volume 113 - Issue - p S344-S345
Specialty: Gastroenterology
Objective: Evaluation
Year Of Study: 2012
Abbreviation: UCEIS
Article By: Denise Nedea
Published On: November 26, 2020 · 12:00 AM
Last Checked: November 26, 2020
Next Review: November 26, 2025