Índices de calificación endoscópica para la evaluación de la actividad de la enfermedad en la colitis ulcerosa
Información
- DOI:
- https://doi.org/10.1002/14651858.CD011450.pub2Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
-
- 16 enero 2018see what's new
- Tipo:
-
- Methodology
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Salud digestiva
- Copyright:
-
- Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
Development of concept: Mark Samaan, Mahmoud H Mosli, Claire E Parker, Sigrid A Nelson, John K MacDonald, Brian G Feagan, GY Zou, Vipul Jairath, Reena Khanna; drafting of manuscript: Nadia Mohammed Vashist, Claire E Parker; critical revision of the manuscript: Nadia Mohammed Vashist, Claire E Parker, Mark Samaan, Mahmoud H Mosli, Claire E Parker, Sigrid A Nelson, John K MacDonald, Brian G Feagan, GY Zou, Reena Khanna, Vipul Jairath.
Declarations of interest
Nadia Mohammed Vashist: None known
Mark Samaan: None known
Mahmoud H Mosl: None known
Claire E Parker: None known
John K MacDonald: None known
Sigrid A Nelson: None known
GY Zou: None known
Brian G Feagan has received Scientific Advisory Board fees from Abbott/AbbVie, Allergan, Amgen, Astra Zeneca, Atlantic Pharma, Avaxia Biologics Inc., Boehringer‐Ingelheim, Bristol‐Myers Squibb, Celgene, Centocor Inc., Elan/Biogen, Ferring, Galapagos, Genentech/Roche, JnJ/Janssen, Merck, Nestles, Novartis, Novonordisk, Pfizer, Prometheus Laboratories, Protagonist, Salix Pharma, Takeda, Teva, TiGenix, Tillotts Pharma AG, and UCB Pharma; consulting fees from Abbott/AbbVie, Ablynx, Akebia Therapeutics, Allergan, Amgen, Applied Molecular Transport Inc., Aptevo Therapeutics, Astra Zeneca, Atlantic Pharma, Avir Pharma, Baxter Healthcare Corp., Biogen Idec, Boehringer‐Ingelheim, Bristol‐Myers Squibb, Calypso Biotech, Celgene, Elan/Biogen, EnGene, Ferring Pharma, Roche/Genentech, Galapagos, GiCare Pharma, Gilead, Given Imaging Inc., GSK, Inception IBD Inc, Ironwood Pharma, Janssen Biotech (Centocor), JnJ/Janssen, Kyowa Kakko Kirin Co Ltd., Lexicon, Lilly, Lycera BioTech, Merck, Mesoblast Pharma, Millennium, Nektar, Nestles, Nextbiotix, Novonordisk, Pfizer, Prometheus Therapeutics and Diagnostics, Progenity, Protagonist, Receptos, Roche/Genentech, Salix Pharma, Serano, Shire, Sigmoid Pharma, Synergy Pharma Inc., Takeda, Teva Pharma, TiGenix, Tillotts, UCB Pharma, Vertex Pharma, Vivelix Pharma, VHsquared Ltd., Warner‐Chilcott, Wyeth, Zealand, Zyngenia; grants/grants pending from AbbVie Inc., Amgen Inc., AstraZeneca/MedImmune Ltd., Atlantic Pharmaceuticals Ltd., Boehringer‐Ingelheim, Celgene Corporation, Celltech, Genentech Inc/Hoffmann‐La Roche Ltd., Gilead Sciences Inc., GlaxoSmithKline (GSK), Janssen Research & Development LLC., Pfizer Inc., Receptos Inc. / Celgene International, Sanofi, Santarus Inc., Takeda Development Center Americas Inc., Tillotts Pharma AG, UCB; and lecture fees from Abbott/AbbVie, JnJ/Janssen, Lilly, Takeda, Tillotts, UCB Pharma.
Reena Khanna has received honoraria from AbbVie, Jansen, Pfizer, Shire, Takeda, and Robarts Clinical Trials for consultancy. All of these activities are outside the submitted work.
Vipul Jairath has received scientific advisory board fees from Abbvie, Sandoz, Ferring, Pfizer and Janssen; speakers fees from Takeda, Ferring, Shire Janssen, Pfizer; travel support for conference attendance from Vifor pharmaceuticals. All of these activities are outside the submitted work.
Acknowledgements
Partial funding for the Cochrane IBD Group (April 1, 2016 ‐ March 31, 2018) has been provided by Crohn's and Colitis Canada (CCC).
Version history
| Published | Title | Stage | Authors | Version |
| 2018 Jan 16 | Endoscopic scoring indices for evaluation of disease activity in ulcerative colitis | Review | Nadia Mohammed Vashist, Mark Samaan, Mahmoud H Mosli, Claire E Parker, John K MacDonald, Sigrid A Nelson, GY Zou, Brian G Feagan, Reena Khanna, Vipul Jairath | |
| 2015 Jan 02 | Endoscopic scoring indices for evaluation of disease activity in ulcerative colitis | Protocol | Mahmoud Mosli, Mark Samaan, Sigrid A Nelson, Brian G Feagan, Simon Travis, Geert D'Haens, William J Sandborn, GY Zou, John K MacDonald, Barrett G Levesque | |
Differences between protocol and review
The methods for assessing the risk of bias in included studies was modified from the protocol. It was planned that risk of bias was to be assessed using blinded design, independent observation, performance bias and detection bias. Since this is a review of scoring indices rather than interventions, the last two items are not applicable. We chose to assess blinded design and independent observation combined with the use of a system based on the COSMIN tool to further assess risk bias.
The method for interpreting correlation coefficients was modified from the protocol. In the protocol we indicated that we would use the Landis and Koch criteria for the interpretation of correlation coefficients that were generated to assess observer agreement (Landis 1977). For the interpretation of correlation coefficients calculated to assess the direction and strength of a relationship between two variables (e.g. UCEIS and CRP), we decided to use the Cohen criteria (Cohen 1992).
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Humans;
Study flow diagram.
| Index | Reference | Validation study ID | |
| 1 | Azzolini Classification | ||
| 2 | Baron Score | Burger 2011; Hirai 2010; Jun 2008; Osada 2010; Thomas 2009; Walsh 2009 | |
| 3 | Blackstone Endoscopic Interpretation | ||
| 4 | CGSUC | ||
| 5 | Endoscopic Activity Index (EAI) | ||
| 6 | Jeroen Score | ||
| 7 | Magnifying Colonoscopy Grade | ||
| 8 | Matts Score | ||
| 9 | Mayo Clinic Endoscopic Subscore | Daperno 2011; Dhanda 2012; Osada 2010; Rubin 2012; Walsh 2009 | |
| 10 | Modified Mayo Clinic Endoscopic Subscore | ||
| 11 | Modified Baron Score | ||
| 12 | Osada Score (Modified 6‐Point Activity Index) | ||
| 13 | Rachmilewitz Endocopic Score | ||
| 14 | St. Mark's Index (Powell‐Tuck Index) | ||
| 15 | Ulcerative Colitis Colonoscopic Index of Severity (UCCIS) | ||
| 16 | Ulcerative Coltiis Disease Activity Index (endoscopic) (Sutherland Index) | ||
| 17 | Ulcerative Colitis Endoscopic Index of Severity (UCEIS) | ||
| 18 | Truelove and Witts Sigmoidoscopic Score | ||
| 19 | Watson Grade |
| Index | Reference | |
| 1 | Beattie Score | |
| 2 | Binder Score | |
| 3 | Carbonnel Score | |
| 4 | Danielsson‐Löfberg Score | |
| 5 | Dick Score | |
| 6 | Friedmann Score | |
| 7 | Froslie Endoscopic Score | |
| 8 | Lemann Score | |
| 9 | Levine Score | |
| 10 | Lindgren Score | |
| 11 | Maier Score | |
| 12 | McPhee Proctoscopic Grading Scale | |
| 13 | Rutter Score | |
| 14 | Saverymuttu Score | |
| 15 | Sigmoidoscopic Index | |
| 16 | Sigmoidoscopic Inflammation Grade Scale/Lemann Score | |
| 17 | Truelove and Richards Sigmoidoscopic Appearance | |
| 18 | van der Heide Index |
| Study ID | Index | Inter‐rater ƙ (between raters) | Inter‐rater ICC (between raters) | Intra‐rater ƙ (within rater) | Intra‐rater ICC (within rater) | Internal Consistency |
| Mayo Clinic Endoscopic Subscore | pre‐training: 0.445 post‐training: 0.713 | |||||
| Mayo Clinic Endoscopic Subscore | experts: 0.53 non‐experts: 0.71 | |||||
| EAI | experts: 0.97 (95% CI 0.92‐1.00) non‐experts: 0.79 (95% CI 0.71‐0.49) | |||||
| Watson Grade | 0.87 | |||||
| Modified 6‐point Activity Index | experts: 0.65 trainees: 0.54 | experts: 0.79 trainee: 0.64 | ||||
| Matts Score | experts: 0.76 trainees: 0.44 | experts: 0.78 trainees: 0.41 | ||||
| The Mayo Endoscopic Subscore | experts: 0.74 trainees: 0.46 | experts: 0.75 trainees: 0.48 | ||||
| Baron Score | experts: 0.61 trainees: 0.47 | experts: 0.62 trainees: 0.46 | ||||
| Blackstone Score | experts: 0.57 trainees: 0.46 | experts: 0.73 trainees: 0.51 | ||||
| UCCIS | Vascular pattern rectum: 0.75 sigmoid: 0.81 descending colon: 0.74 transverse colon: 0.86 ascending/cecum: 0.85 Granularity rectum: 0.70 sigmoid: 0.78 descending colon: 0.73 transverse colon: 0.88 ascending/cecum: 0.82 Ulceration rectum: 0.80 sigmoid: 0.75 descending colon: 0.72 transverse colon: 0.73 ascending/cecum: 0.73 Bleeding/Friability rectum: 0.68 sigmoid: 0.58 descending colon: 0.56 transverse colon: 0.73 ascending/cecum: 0.77 SAES rectum: 0.79 sigmoid: 0.78 descending colon: 0.71 transverse colon: 0.84 ascending/cecum: 0.85 | |||||
| UCEIS | 0.50 | 0.72 | 0.863* | |||
| * Cronbach alpha analysis SAES: segmental assessment of endoscopic severity | ||||||
| Study ID | Index | Comparison | Correlation |
| Magnifying Colonscopy Grade | Mucosal IL‐8 activity | ρ = NS (P < 0.001) | |
| UCCIS | C‐reactive protein | r = 0.56 (P < 0.001) | |
| albumin | r = ‐0.55 (P < 0.001) | ||
| hemoglobin | r = ‐0.39 (P < 0.01) | ||
| platelet count | r = 0.19 (P > 0.05) | ||
| Rachmilewitz Endoscopic Score | Fecal calprotectin | r = 0.834 (P < 0.001) | |
| C‐reactive protein | r = 0.503 (P < 0.001) | ||
| Blood leukocytes | r = 0.461 (P < 0.001) |
| Study ID | Index | Comparison | Correlation |
| Baron Score | SCCAI | ƙ = 0.27 | |
| Truelove and Richards Index | ƙ = 0.58 | ||
| Mayo Clinic Endoscopic Subscore | Riley Score | Week 4 r = 0.55 | |
| St. Mark's Index | UCDAI | r = 0.881 (95% CI 0.814‐0.925); ρ = 0.867 | |
| SCCAI | r = 0.908 (95% CI 0.855‐0.924); ρ = 0.866 | ||
| Seo Index | r = 0.803 (95% CI 0.699‐0.873); ρ = 0.705 | ||
| Baron Score | Rachmilewitz Score | Week 0 r = 0.39 (95% CI 0.18‐0.57, P = 0.0004) Week 4 r = 0.56 (95% CI 0.36‐0.71, P < 0.0001) Week 8 r = 0.76 (95% CI 0.60‐0.85, P < 0.0001) | |
| UCDAI | Week 0 r = 0.49 (95% CI 0.29‐0.64, P < 0.0001) Week 4 r = 0.72 (95% CI 0.57‐0.82, P < 0.0001) Week 8 r = 0.85 (95% CI 0.74‐0.91, P < 0.0001) | ||
| Seo Index | Week 0 r = 0.29 (95% CI 0.06‐0.49, P = 0.01) Week 2 r = 0.29 (95% CI 0.04‐0.51, P = 0.02) Week 4 r = 0.53 (95% CI 0.29‐0.70, P < 0.0001) | ||
| Lichtiger Index | Week 0 r = 0.47 (95% CI 0.26‐0.62, P < 0.0001) Week 4 r = 0.56 (95% CI 0.35‐0.71, P < 0.0001) Week 8 r = 0.78 (95% CI 0.64‐0.78, P < 0.0001) | ||
| Rachmilewitz Endoscopic Score | Rachmilewitz Score | Week 0 r = 0.34 (95% CI 0.11‐0.52, P = 0.0003) Week 2 r = 0.66 (95% CI 0.48‐0.78, P < 0.0001) Week 4 r = 0.89 (95% CI 0.73‐0.71, P < 0.0001) | |
| UCDAI | Week 0 r = 0.44 (95% CI 0.23‐0.60, P < 0.0001) Week 4 r = 0.79 (95% CI 0.67‐0.87, P < 0.0001) Week 8 r = 0.89 (95% CI 0.82‐0.94, P < 0.0001) | ||
| Lichtiger Index | Week 0 r = 0.35 (95% CI 0.13‐0.54, P =0.002) Week 4 r = 0.28 (95% CI 0.02‐0.49, P = 0.003) Week 8 r = 0.65 (95% CI 0.44 to 0.78, P < 0.0001) | ||
| Seo Index | Week 0 r = 0.33 (95% CI 0.10‐0.51, P = 0.005) Week 4 r = 0.67 (95% CI 0.50‐0.79, P < 0.0001) Week 8 r = 0.80 (95% CI 0.67‐0.88, P < 0.0001) | ||
| CGSUC | Truelove and Witts Score | ρ = 0.750 (P < 0.001) | |
| Baron Score | ρ = 0.740 (P < 0.001) | ||
| Modified Baron Score | ρ = 0.742 (P < 0.001) | ||
| Jeroen Score | ρ = 0.799 (P < 0.001) | ||
| Azzolini Score | ρ = 0.685 (P < 0.001) | ||
| Truelove and Witts Score | CGSUC | ρ = 0.750 (P < 0.001) | |
| Baron Score | ρ = 0.814 (P < 0.001) | ||
| Modified Baron Score | ρ = 0.760 (P < 0.001) | ||
| Jeroen Score | ρ = 0.782 (P < 0.001) | ||
| Azzolini Score | ρ = 0.756 (P < 0.001) | ||
| Baron Score | CGSUC | ρ = 0.740 (P < 0.001) | |
| Truelove and Witts Score | ρ = 0.814 (P < 0.001) | ||
| Modified Baron Score | ρ = 0.750 (P < 0.001) | ||
| Jeroen Score | ρ = 0.828 (P < 0.001) | ||
| Azzolini Score | ρ = 0.732 (P < 0.001) | ||
| Modified Baron Score | CGSUC | ρ = 0.742 (P < 0.001) | |
| Baron Score | ρ = 0.760 (P < 0.001) | ||
| Truelove and Witts Score | ρ = 0.750 (P < 0.001) | ||
| Jeroen Score | ρ = 0.761 (P < 0.001) | ||
| Azzolini Score | ρ = 0.693 (P < 0.001) | ||
| Jeroen Score | CGSUC | ρ = 0.799 (P < 0.001) | |
| Baron Score | ρ = 0.782 (P < 0.001) | ||
| Truelove and Witts Score | ρ = 0.828 (P < 0.001) | ||
| Modified Baron Score | ρ = 0.761 (P < 0.001) | ||
| Azzolini Score | ρ = 0.788 (P < 0.001) | ||
| Azzolini Score | CGSUC | ρ = 0.685 (P < 0.001) | |
| Truelove and Witts Score | ρ = 0.756 (P < 0.001) | ||
| Baron Score | ρ = 0.732 (P < 0.001) | ||
| Modified Baron Score | ρ = 0.693 (P < 0.001) | ||
| Jeroen Score | ρ = 0.788 (P < 0.001) | ||
| EAI | Lichtiger Index | r = 0.77 (P < 0.001) | |
| Matts Score | r = 0.91 (P < 0.001) | ||
| Rachmilewitz Endoscopic Score | r = 0.87, (P < 0.001) | ||
| Magnifying Colonoscopy Grade | Riley Score | ρ = NS (P < 0.001) | |
| Mayo Clinic Endoscopic Subscore | SCCAI | r = 0.525 (P < 0.0001) | |
| Rubin Histologic Score | r = 0.597 (P < 0.0001) | ||
| UCCIS | SCCAI | r = 0.62 (P < 0.0001) | |
| Rachmilewitz Score | r = 0.5 (P < 0.001) | ||
| Patient‐Defined Remission Score | r = 0.43 (P < 0.01) | ||
| Rachmilewitz Score (endoscopic) | Rachmilwitz Score (clinical) | r = 0.672 (P < 0.01) | |
| Baron Score | Truelove and Richards Score | ƙ = 0.58 | |
| SCCAI | ƙ = 0.27 | ||
| UCEIS | Visual Analogue Scale | median 0.93 across investigators (minimum 0.78, maximum 0.99) statistically significant P > 0.05 | |
| Baron Score | Modified Baron Score | ƙ = 0.89 | |
| Baron Score | Mayo Endoscopic Subscore | ƙ = 0.83 | |
| ρ = Spearman's rank correlation coefficient Abbreviations: CGSUC, Chinese Grading Score for Ulcerative Colitis; EAI, Endoscopic Activity Index; IL, Interleukin; NS, Not Stated; SCCAI, Simple Clinical Colitis Activity Index | |||
| Study ID | Index | Treatment | Effect size (95% CI) | Guyatt's responsiveness statistic (95% CI) | Area under the ROC curve (95% CI) | Mean change (P value) |
| Mayo Clinic Endoscopic Subscore | Asacol | 0.49 (0.28, 0.71) | 0.32 (0.11, 0.53) | 0.66 (0.55, 0.78) | ||
| Modified Baron Score | 0.49 (0.28, 0.71) | 0.33 (0.13, 0.54) | 0.65 (0.54, 0.77) | |||
| UCEIS | 0.58 (0.36, 0.81) | 0.47 (0.25, 0.69) | 0.68 (0.58, 0.79) | |||
| Mayo Clinic Endoscopic Subscore | Tacrolimus | 2.9 (+/‐ 0.9) to 2.0 (+/‐ 1.0) (P < 0.001) | ||||
| UCEIS | 6.2 (+/‐ 0.9) to 3.4 (+/‐ 2.1) (P < 0.001) |
| A | B | C | D | E | F | G | H | I | J | ||
| Study ID | IC | RB | ME | COV | FA | HT | CCV | CRV | RP | IT | GN |
| ‐ | ‐ | ‐ | ‐ | ‐ | good | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | good | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | good | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | ‐ | ‐ | ‐ | ‐ | excellent | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | ‐ | ‐ | ‐ | ‐ | good | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | ‐ | ‐ | ‐ | ‐ | good | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | fair | ‐ | ‐ | |
| ‐ | ‐ | ‐ | ‐ | ‐ | good | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | good | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | excellent | ‐ | ‐ | |
| ‐ | ‐ | ‐ | ‐ | ‐ | excellent | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | ‐ | ‐ | ‐ | ‐ | good | ‐ | good | ‐ | ‐ | ‐ | |
| ‐ | excellent | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | good | ‐ | ‐ | ‐ | good | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | excellent | ‐ | ‐ | ‐ | excellent | ‐ | excellent | ‐ | ‐ | ‐ | |
| ‐ | ‐ | ‐ | ‐ | ‐ | excellent | ‐ | excellent | ‐ | ‐ | ‐ | |
| ‐ | ‐ | ‐ | ‐ | ‐ | good | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | good | ‐ | ‐ | ‐ | good | ‐ | ‐ | ‐ | ‐ | ‐ | |
| ‐ | ‐ | ‐ | ‐ | ‐ | excellent | ‐ | ‐ | ‐ | ‐ | ‐ | |
| IC ‐ internal consistency; RB ‐ reliability; ME ‐ measurement error; COV ‐ content validity; FA ‐ factor analysis; HT ‐ hypothesis testing; CCV ‐ cross cultural validity; CRV ‐ criterion validity; RP ‐ responsiveness; IT ‐ interpretability; GN ‐ generalizability | |||||||||||
| Scoring index | Validity | Reliability | Responsiveness | Feasibility | |||||
| Content validity | Criterion validity | Construct validity | Intra‐rater | Inter‐rater | Test‐retest | Internal consistency | |||
| Azzolini Classification | ? | ? | + | ? | ? | ? | ? | ? | ? |
| Baron Score | ? | ? | + | + | + | ? | ? | ? | ? |
| Blackstone Endoscopic Interpretation | ? | ? | ? | + | + | ? | ? | ? | ? |
| CGSUC | ? | ? | + | ? | ? | ? | ? | ? | ? |
| Endoscopic Activity Index (EAI) | ? | ? | + | ? | + | ? | ? | ? | ? |
| Jeroen Score | ? | ? | + | ? | ? | ? | ? | ? | ? |
| Magnifying Colonscopy Grade | ? | + | + | ? | ? | ? | ? | ? | ? |
| Matts Score | ? | ? | + | + | + | ? | ? | ? | ? |
| Mayo Clinic Endoscopic Subscore | ? | ? | + | + | + | ? | ? | + | ? |
| Modified Mayo Clinic Endoscopic Subscore | ? | ? | ? | ? | ? | ? | ? | + | ? |
| Modified Baron Score | ? | ? | + | ? | + | ? | ? | + | ? |
| Osada Score (Modified 6‐Point Activity Index) | ? | ? | ? | + | + | ? | ? | ? | ? |
| Rachmilewitz Endocopic Score | ? | + | + | ? | ? | ? | ? | ? | ? |
| St. Mark's Index (Powell‐Tuck Index) | ? | ? | + | ? | ? | ? | ? | ? | ? |
| Ulcerative Colitis Colonoscopic Index of Severity (UCCIS) | ? | ? | ? | ? | ? | ? | ? | ? | ? |
| Ulcerative Coltiis Disease Activity Index (endoscopic) (Sutherland Index) | ? | ? | ? | ? | ? | ? | ? | ? | ? |
| Ulcerative Colitis Endoscopic Index of Severity (UCEIS) | ? | ? | ? | ? | ? | ? | ? | ? | ? |
| Truelove and Witts Sigmoidoscopic Score | ? | ? | ? | ? | ? | ? | ? | ? | ? |
| Watson Grade | ? | ? | ? | ? | + | ? | ? | ? | ? |
| + positive rating ? no information or indeterminate rating ‐ Negative rating | |||||||||
