Harvey Bradshaw Index Calculator

The Harvey Bradshaw Index (HBI) is used to assess the severity of Crohn's disease activity, a chronic inflammatory bowel disease. This simple calculator provides a way to evaluate a patient’s disease activity based on several factors such as general well-being, abdominal pain, bowel frequency, complications, and presence of an abdominal mass. Each factor is scored, and the total provides an indication of disease activity.

Historical Background

The HBI was developed as a modification of the Crohn’s Disease Activity Index (CDAI) in the 1980s by Harvey and Bradshaw. The index simplifies disease monitoring by reducing the number of variables, making it easier for clinicians to assess patients during routine visits.

Calculation Formula

The Harvey Bradshaw Index (HBI) is calculated as the sum of five key components:

\[ \text{HBI} = \text{General Wellbeing} (0-4) + \text{Abdominal Pain} (0-3) + \text{Number of Liquid Stools per Day} + \text{Complications} (0-1) + \text{Abdominal Mass} (0-3) \]

Where:

• General Wellbeing is rated on a scale of 0 (well) to 4 (terrible).
• Abdominal Pain is scored from 0 (none) to 3 (severe).
• Bowel Frequency represents the number of liquid stools per day.
• Complications accounts for extra-intestinal complications like abscesses or fistulas, scored as 0 (none) or 1 (present).
• Abdominal Mass ranges from 0 (none) to 3 (definite and tender).

Example Calculation

For a patient presenting with:

• General Wellbeing: 2
• Abdominal Pain: 1
• Bowel Frequency: 5
• Complications: 0
• Abdominal Mass: 1

The HBI calculation would be:

\[ \text{HBI} = 2 + 1 + 5 + 0 + 1 = 9 \]

Importance and Usage Scenarios

The HBI is widely used in clinical settings to monitor Crohn’s disease over time and guide treatment decisions. A higher score indicates more severe disease activity:

• Mild Disease: HBI < 5
• Moderate Disease: HBI 5-7
• Severe Disease: HBI > 7

It helps doctors assess response to therapy and decide on treatment adjustments. It is especially useful in outpatient visits or when rapid disease assessment is needed.

Common FAQs

1. What is the difference between HBI and CDAI?

   • The HBI is a simplified version of the CDAI, using fewer variables and a more practical scoring method for routine clinical use.

2. What does a high HBI score indicate?

   • A high HBI score indicates more severe Crohn’s disease activity, potentially requiring more aggressive treatment.

3. Can the HBI be used to diagnose Crohn's disease?

   • No, the HBI is not a diagnostic tool. It is used to monitor disease activity in patients already diagnosed with Crohn's disease.

This calculator is essential for gastroenterologists and clinicians involved in the long-term management of Crohn's disease. It enables rapid assessment of disease status, aiding in the timely adjustment of treatment strategies.