P092. Developing a short form Crohn's and Colitis Questionnaire (CCQ) for patients with inflammatory bowel disease
L. Alrubaiy1, W.‑Y. Cheung1, I. Russell1, J. Williams1
1College of Medicine, Swansea University, Swansea, United Kingdom
Background: All specific Quality of life measurement tools for patients with inflammatory bowel disease have been designed for use with outpatients with chronic disease and none are suitable for use with acutely ill patients and those who have a stoma. Our aim was to develop a short quality of life questionnaire Crohn's and Colitis Questionnaire (CCQ) for use in the acute and chronic setting, and patients with stoma.
Methods: Based on the UK Inflammatory Disease Questionnaire which has been developed and validated in 2000, we derived the CCQ which has supplementary questions to reflect the wider range and frequency of symptoms in patients with inflammatory bowel disease. We then analysed baseline questionnaires completed by the 124 patients. A short form of the CCQ was derived by regressing the total CCQ on the 32 individual items. Internal consistency was assessed by item-total correlation and Cronbach alpha. Construct Validity was assessed by comparing it with SF12 and EQ5D.
Results: We found that 12 items together accounted for 95% of the variation in total scores between patients: sleeping, appetite, energy level, rushing to toilet, being bloated, incomplete emptying of bowels, blood in stool, generally unwell, faecal incontinence, nocturnal diarrhoea, passing winds and effect on leisure activities.
Reassuringly, none of these items had item-total correlations greater than 0.8, showing that all items added extra information and none had a single response chosen by more than 80% of patients i.e. all items give good discrimination. However two of the top 12 faecal incontinence and passing winds have item-total correlations less than 0.2, suggesting that they may not be measuring severity. So these items are candidates for removal from the short form. Indeed, since the top 8 items together accounted for 92% of the variation in total scores, they have the potential to form the definitive short form.
We have also checked construct validity against the SF12 and EQ5D. Correlations of the short form with SF12 PCS (−0.421), SF12 MCS (−0.400) and EQ5D (−0.398) were around −0.4 demonstrating good evidence of construct validity as recommended by Streiner and Norman. It is clear that the short CCQ performs well in this population and is very likely to yield a valid and efficient short form.
Conclusions: We have developed a short quality of life measurement tool for patients with inflammatory bowel disease managed in community, hospital as well as patients with stoma.