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P108. Towards patient-reported disease severity index in inflammatory bowel disease

L. Alrubaiy1,2, J. Williams1, H. Hutchings1, 1Swansea University, College of Medicine, Swansea, United Kingdom, 2Royal Gwent Hospital, Gastroenterology, Newport, United Kingdom

Background

Most disease severity indices in inflammatory bowel disease (IBD) were not properly validated. Our aim is to develop the first patient reported clinical disease severity index that is valid, easy obtainable for all IBD patients.

Methods

Items were devised through extensive literature review of the clinical severity indices commonly used for ulcerative colitis (UC) and Crohn's disease (CD). A focus group of IBD specialists reviewed these items to ensure good face and content validity. Psychometric properties were tested on 255 patients with UC and CD to shorten the index. Construct validity was checked using biochemical markers, clinical indices and endoscopic indices.

Results

We found that 8 items account for 98% of the variance of the total score which were: Abdominal pain, stool consistency, blood in stool, stool frequency, general well being, nocturnal symptoms, functional status and urgency. Items that had high item total correlation >0.8 like physician global assessment were removed from the index as they are redundant. Temperature and abdominal mass had a zero variance score and were removed during principle component analysis. Internal consistency (Correlation of items with each other) was acceptable (Cronbach alpha = 0.827). SICSI had good correlation with the CRP, clinical, and endoscopic severity scores (r > 0.5). Test–retest and inter-observer reliability was very good (r = 0.9).

Conclusion

This is the first validated patient reported clinical severity index in IBD. It is clear that this index will perform well in clinical practice and will be invaluable tool in research.