Simplified patient-reported outcome scores, known as PRO2 and PRO3, can be calculated in more than 80% of real-world clinic visits for Crohn’s disease, offering a practical alternative to complex traditional indices that restrict routine and telehealth monitoring, according to a study published on October 1, 2026, in Gastro Hep Advances.
Real-World Feasibility of Patient-Reported Measures
Traditional disease activity tracking tools like the Crohn’s Disease Activity Index (CDAI) and the Harvey-Bradshaw Index (HBI) demand laboratory values and physical examination findings that clinics frequently miss during standard patient encounters. To test whether simpler metrics could fill this gap, researchers led by Wai Kin Su at Liverpool Hospital in Liverpool, Australia, examined 26,230 clinical assessments recorded since 2018 in an electronic medical record system spanning Australia and New Zealand.
During every clinical appointment, patients recorded three particular metrics over set periods: the number of liquid stools in the previous 24 hours, their mean general well-being over the previous 7 days, and their mean abdominal pain over the previous 7 days. These inputs formed the basis for the PRO2 and PRO3 scores, while the CDAI and HBI scores were calculated only when clinicians entered the necessary additional laboratory and physical examination data.
Comparison of Scoring Availability and Severity Agreement
The administrative burden of traditional indices showed up clearly in the data. Out of the 26,230 total visits analyzed, the CDAI could only be calculated in 6,509 visits, or 24.8%. The HBI fared similarly, available in just 7,043 visits, or 26.9%. In stark contrast, the patient-driven scores bypassed these laboratory bottlenecks entirely. The PRO2 score was successfully calculated in 21,416 visits, reaching 81.6% availability, while the PRO3 score appeared in 21,234 visits, or 81.0%.
To determine clinical reliability, the research team evaluated how often each pair of scores categorized disease activity into the same severity tiers—remission, mild, moderate, or severe. The PRO2 score showed an 87.6% agreement rate with the CDAI and a 93.3% agreement rate with the HBI. The PRO3 score demonstrated similar reliability, with an 86.8% agreement with the CDAI and an 88.2% agreement with the HBI.
When the scores did not align perfectly, the discrepancies were minor. Between 92.1% and 98.5% of any scoring mismatches were off by only a single severity level. The statistical tracking confirmed that these streamlined, patient-logged inputs capture nearly the same clinical information as data-intensive legacy indices.
Clinical Insight: The study authors noted that PRO2 and PRO3 provide valid and reliable alternatives to the CDAI and HBI. Their simple, objective design allows for seamless integration across telehealth platforms and digital health systems, which could improve longitudinal monitoring in routine clinical practice.
Common Questions About Crohn’s Disease Tracking Scores
What inputs are required to calculate PRO2 and PRO3 scores?
Three specific metrics are provided by patients: average general well-being over the last 7 days, average abdominal pain over the last 7 days, and the quantity of liquid stools during the preceding 24 hours.
Why are traditional indices like the CDAI difficult to use in routine care?
The CDAI and HBI require specific laboratory values and physical examination results that are not always captured during standard point-of-care or telehealth visits.
Did the study receive external funding?
No funding was reported for the research. Two study authors disclosed receiving speaker fees, educational support, honoraria for advisory board participation, and research support from multiple companies.