erefs_score: Eosinophilic Esophagitis Endoscopic Reference Score (EREFS)

In cliot: Clinical Indices and Outcomes Tools

Eosinophilic Esophagitis Endoscopic Reference Score (EREFS)

Description

Calculates the EREFS score, a standardized grading system for endoscopic findings in Eosinophilic Esophagitis (EoE). The score quantifies the severity of five major endoscopic features: Edema, Rings, Exudates, Furrows, and Strictures. It also provides subscores for inflammatory (Edema, Exudates, Furrows) and fibrostenotic (Rings, Stricture) features.

Usage

erefs_score(edema, rings, exudates, furrows, stricture)

Arguments

edema	Numeric (0-1). Presence of edema (loss of vascular markings). 0: Absent (distinct vascularity). 1: Present (decreased or absent vascularity/pallor).
rings	Numeric (0-3). Presence of trachealization/rings. 0: Absent. 1: Mild (ridges). 2: Moderate (distinct rings). 3: Severe (fixed rings, prevents scope passage).
exudates	Numeric (0-2). Presence of white plaques/exudates. 0: Absent. 1: Mild (<10% of surface area). 2: Severe (>10% of surface area).
furrows	Numeric (0-2). Presence of vertical lines/furrows. 0: Absent. 1: Mild (vertical lines without visible depth). 2: Severe (vertical lines with visible depth).
stricture	Numeric (0-1). Presence of stricture (narrowing). 0: Absent. 1: Present.

Value

A list containing:

EREFS_Total_Score	The sum of all component scores (Range 0-9).
Subscores	A list containing the Inflammatory Score (Range 0-5) and Fibrostenotic Score (Range 0-4).

References

Hirano I, Moy N, Heckman MG, Thomas CS, Gonsalves N, Achem SR. Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading system. Gut. 2013;62(4):489-495. doi:10.1136/gutjnl-2011-301817

Examples

# Example 1: Mixed Phenotype
# Edema(1), Rings(2), Exudates(1), Furrows(1), Stricture(0)
# Total = 5 (Inflammatory 3, Fibrostenotic 2)
erefs_score(1, 2, 1, 1, 0)

# Example 2: Severe Inflammatory
# Edema(1), Rings(0), Exudates(2), Furrows(2), Stricture(0)
# Total = 5 (Inflammatory 5, Fibrostenotic 0)
erefs_score(1, 0, 2, 2, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.