The O.M.G.E. Multinational Inflammatory Bowel Disease Survey 1976-1982. A further report on 2,657 cases

Abstract

This presentation describes the progress during 1978-1982 of the O.M.G.E. Multinational Survey of patients with inflammatory bowel disease. After a brief description of the study design and protocol, and review of results up to 1978, the status of the survey in 1982 is presented. In all, 35 centres contributed 2,657 cases at that time; data collection being meticulous via previously designed proformata. Diagnostic criteria are next discussed. Little change between 1978 and 1982 is noted, with wide variation in the UC/CD ratio for individual centres, but continuing evidence of a congruence of diagnostic thought, now codified into a simple (and recommended) O.M.G.E. Scoring System. Patients seen prior to 1978 were reviewed in 1982. Where attempted, a follow-up of over 90% was achieved, usually more than four years after the original presentation. Interesting data resulted. The stability of diagnosis was high, only 3.4% of patient diagnoses changing between 1978 and 1982. The mortality of Crohn's disease patients, usually unrelated to surgery, was higher than that of ulcerative colitis patents, and the cancer risk identical in the two groups. Most patients were well at review; but--though asymptomatic--were usually on prophylactice therapy, most commonly with salazopyrine. Finally, problems in assessing severity and activity of disease are discussed, and joint studies between O.M.G.W. and the newly formed International Organisation for the Study of I.B.D. described. As regards Crohn's disease, several 'indices of activity' already exist; when tested on a set of 200 O.M.G.E. patients, indices did not correlate well with each other, or with patient prognosis. Further studies are suggested during 1982-1986.