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Harvey-Bradshaw Index (HBI) for Crohn's Disease

Simple clinical activity index for Crohn's disease based on symptoms and exam.

Harvey-Bradshaw Index (HBI) for Crohn's Disease
General well-being
Abdominal pain
Number of liquid/soft stools per day
/day
Abdominal mass
Number of complications
1 point each: arthralgia, uveitis, erythema nodosum, aphthous ulcers, pyoderma gangrenosum, anal fissure, new fistula, abscess.
conditions
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When to use

  • Bedside clinical assessment of Crohn's disease activity without needing laboratory tests, as a simplified alternative to the Crohn's Disease Activity Index (CDAI).

Formula

HBI = general well-being(0-4) + abdominal pain(0-3) + liquid stools/day (1 point each) + abdominal mass(0-3) + number of listed complications (1 point each). <5 = remission; 5-7 = mild; 8-16 = moderate; >16 = severe.

Pearls and pitfalls

  • Correlates well with the more complex CDAI while being far quicker to obtain.
  • Does not include laboratory markers, so should be interpreted alongside CRP/faecal calprotectin and endoscopic findings when available.

References

  1. Harvey RF, Bradshaw JM. A simple index of Crohn's-disease activity. Lancet. 1980;1(8167):514.