truelove_witts_severity_index: Truelove and Witts Severity Index for Ulcerative Colitis

In cliot: Clinical Indices and Outcomes Tools

Truelove and Witts Severity Index for Ulcerative Colitis

Description

Calculates the Truelove and Witts Severity Index to classify the severity of an Ulcerative Colitis flare. The classification is based on six criteria: stool frequency, rectal bleeding, temperature, pulse, hemoglobin, and ESR.

Usage

truelove_witts_severity_index(bowel_movements_per_day, rectal_bleeding,
                              temperature_c, heart_rate, hemoglobin_g_dl, esr)

Arguments

bowel_movements_per_day	Numeric. Number of bowel movements per day.
rectal_bleeding	String. Presence of blood in stool. Options: "none" (small/none), "intermittent", "frequent_continuous" (visible blood).
temperature_c	Numeric. Body temperature in degrees Celsius. (> 37.5 C is a severe criterion).
heart_rate	Numeric. Pulse rate in beats per minute. (> 90 bpm is a severe criterion).
hemoglobin_g_dl	Numeric. Hemoglobin level in g/dL. (<= 10.5 g/dL is a severe criterion).
esr	Numeric. Erythrocyte Sedimentation Rate in mm/hr. (> 30 mm/hr is a severe criterion).

Details

Classification logic: - **Severe**: >= 6 bloody stools/day AND at least one sign of systemic toxicity (Temp > 37.5, HR > 90, Hgb <= 10.5, or ESR > 30). - **Mild**: < 4 stools/day, with no or intermittent bleeding, and normal vital signs/labs. - **Moderate**: Intermediate between Mild and Severe (e.g., > 4 stools but not meeting severe criteria).

Value

A list containing:

Severity_Index

The severity classification (Mild, Moderate, Severe).

References

Truelove SC, Witts LJ. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955;2(4947):1041-1048. doi:10.1136/bmj.2.4947.1041

Examples

# Example 1: Severe Colitis
# 8 stools, frequent blood, HR 100, Temp 38
truelove_witts_severity_index(8, "frequent_continuous", 38.0, 100, 11.0, 25)

# Example 2: Mild Colitis
# 3 stools, intermittent blood, normal vitals/labs
truelove_witts_severity_index(3, "intermittent", 37.0, 70, 14.0, 10)

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