Fecal calprotectin and endoscopic scores: The cornerstones in clinical practice for evaluating mucosal healing in inflammatory bowel disease

Table 3 Endoscopic indices of ulcerative colitis activity with their strengths and limitations

Indices	Endoscopic technique	Validation	Strengths	Limitations
MES	WLE	No	The easiest to use	Subjectivity
			Used in clinical trials and daily practice	Moderate reproducibility
				Not appropriate description of inflammation and severity
				Ambiguous definition of endoscopic remission
UCEIS	WLE	Yes	Easy to use	No thresholds for mild, moderate and severe disease
			Good reproducibility and agreement	No definition of superficial or deep ulcer
			High correlation with clinical, and histological indices and biomarkers
			Clear definition or ER/MH
			Clinically relevant outcomes
UCCIS	WLE	Yes	Good reproducibility and agreement	No definition of MH
			Provides details about the status of inflammation of the entire colonic mucosa	No thresholds for mild, moderate and severe disease
				Few evidence
PICaSSO	VCE-iSCAN	Yes	High reproducibility and agreement	Endoscopy experience and training required.
			Strong accuracy discriminating quiescent from mild disease.	No long-term clinical outcome
			Highest correlation with MH

Adapted from Ruscio et al[89]. ER: Endoscopic remission; HH: Histological healing; MES: Mayo endoscopic subscore; MH: Mucosal healing; PICaSSO: Paddington international virtual chromoendoscopy score; UCCIS: Ulcerative colitis colonoscopic index of severity; UCEIS: Ulcerative colitis endoscopic index of severity; WLE: White-light endoscopy; VCE: Virtual chromoendoscopy.