Clinical decision support

Guidelines & calculators

Practice guidelines and risk calculators

Third-party guidelines and prediction tools relevant to Crohn’s disease, each independently verified against PubMed. These are external documents and tools — linked, not reproduced, and not evidence-gated by this site.

Read the access and validation labels. Very few published IBD prediction tools are simultaneously a live free calculator, externally validated, and validated for the decision you are about to make. Where a tool is formula-only, or was validated only in its derivation cohort, that is stated rather than hidden behind a link. 3 further item(s) found by this review are withheld pending clinician sign-off rather than published unverified.

Practice guidelines

Risk calculators and prediction tools

  • Postoperative recurrence predictive model / nomogram, biologic era (Allez / Hammoudi) paywalledexternally validatedPredicts endoscopic recurrence (modified Rutgeerts >= i2b) within 1 year of ileocolonic resection, and models the risk reduction from prophylactic biologic therapy. · PMID 41905522 Note: AUC 0.72 — risk-stratification only, not a substitute for the guideline-mandated ileocolonoscopy in the first postoperative year. Predicts ENDOSCOPIC, not clinical, recurrence. No hosted web calculator exists; the nomogram must be read off the paywalled paper. Clinically important dissonance: this contemporary cohort (n=632, 78% biologic-exposed) did NOT reproduce penetrating phenotype as a risk factor, although guidelines still list it.
  • MONITOR index (MRI in Crohn's Disease to Predict Postoperative Recurrence) paywalledexternally validatedMRI-based index predicting endoscopic postoperative recurrence (Rutgeerts > i1), as a non-invasive alternative to surveillance ileocolonoscopy. · PMID 34216820 Note: Small: derived from 73 MRI datasets at a single French centre, with a small independent validation cohort. At the proposed threshold (>= 1) specificity is only 55% — it will over-call recurrence. Requires a radiologist to score seven items; no calculator is hosted anywhere.
  • Crohn's Disease Activity Index (CDAI) live calculatorexternally validatedQuantifies symptomatic disease activity; the historical primary endpoint in CD drug trials (remission < 150, moderate 220-450, severe > 450). · PMID 1248701 Note: Explicitly NOT valid in the population this site serves: it performs poorly in stricturing and fistulizing disease, after extensive ileocolonic resection, and in patients with a stoma. It is a symptom score that correlates poorly with endoscopic activity, and MDCalc itself notes it is unaware of any outcome-validated algorithm built on the score. It measures how a patient feels, not surgical risk.
  • Harvey-Bradshaw Index (HBI) live calculatorexternally validatedSimplified clinic-usable CD activity score (remission < 5); the practical stand-in for CDAI in routine care. · PMID 6102236 Note: Inherits every CDAI limitation (symptom-only, blind to transmural and endoscopic disease, unreliable post-resection or with a stoma). The claim of equivalence to CDAI rests on a correlation coefficient of 0.93, which is not the same as agreement; the < 5 remission cut-off is conventional, not outcome-derived. No maximum score, since liquid stool count is unbounded.
  • Perianal Disease Activity Index (PDAI) formula only — no calculatorderivation cohort onlyGrades severity of, and response to treatment in, perianal CD — the domain conventional activity indices miss. · PMID 7884173 Note: Validated only within its own single-centre derivation study (37 patients, 124 visits) against physician and patient global assessment; I found no independent external validation, and heavy use as a trial endpoint is not the same thing. Contains no imaging component, so it cannot distinguish a clinically closed tract from a radiologically healed one. There is no free hosted calculator — it is not on MDCalc; you must reproduce the five items from the 1995 paper.
  • ACS NSQIP Surgical Risk Calculator live calculatorexternally validatedEstimates 30-day risk of death and of individual postoperative complications for a planned procedure by CPT code. Note: Externally validated in several surgical populations but I found NO external validation in Crohn's or IBD bowel resection — treat its output in a CD patient as unvalidated. It cannot see the variables that actually drive CD operative risk: biologic exposure, steroid dose and duration (only a binary 'steroid use' field), severity of malnutrition, intra-abdominal abscess or phlegmon, penetrating phenotype, and reoperative/hostile abdomen. Calibration has already been shown to drift in adjacent colorectal cohorts (complications underestimated in colorectal liver metastasis, non-home discharge overestimated in elderly colorectal cancer). Derivation PMID left blank because the calculator is a maintained registry model, not a single citable derivation paper.