P208 Validation of the IBD-Disk in a Portuguese cohort of patients with inflammatory bowel disease
Garrido, I.(1)*;Lopes, S.(1);Dias, C.(2);Macedo, G.(1);
(1)Centro Hospitalar Universitário de São João, Gastroenterology and Hepatology Department, Porto, Portugal;(2)Faculty of Medicine of Porto University, Department of Community Medicine- Information and Decision in Health, Porto, Portugal;
Background
Inflammatory Bowel Disease-Disability Index (IBD-DI) is a validated tool that was developed for assessing disability and to help clinicians to guide different therapeutic decisions. However, due to its complexity, it is difficult to apply in daily practice. The IBD-Disk is a new shortened adaptation of the IBD-DI, designed to give an immediate representation of disability. However, further investigation is required to validate this tool in clinical practice. The objective of this study was to evaluate the IBD-Disk for its capacity to assess disability in a Portuguese cohort of patients with IBD.
Methods
In this single-center, cross-sectional observational study, patients with IBD were consecutively recruited between February 2021 to February 2022 from our outpatient department. Both IBD-Disk and IBD-DI were delivered and filled out simultaneously by all included patients. Sociodemographic and clinical data were also collected.
Results
A total of 258 patients were included, the majority female (51.9%), with a median age of 41 years old (IQR 32-52). There were 184 (71.3%) individuals with Crohn´s disease and 74 (28.7%) with ulcerative colitis (Table 1). The median total score of IBD-Disk was 29.6±24.4 and that of IBD-DI was 23.8±11.2. The item on the IBD-Disk with the highest score was “energy” (4.33±3.5) and the lowest scoring item was interpersonal interactions (1.98±2.8). A significant positive correlation between total scores of IBD-Disk and IBD-DI was identified (r=0.722, p<0.001), with a high Pearson correlation. Regarding the validity per item, there was also a good correlation between both scores. Including all 10 items in the IBD-Disk scale, a value of 0.918 was observed for Cronbach’s alpha, demonstrating a very good homogeneity of IBD-Disk items. Performing the one-at-a-time removal procedure, Cronbach’s alpha varied between 0.905 and 0.915, confirming that all items contribute to the construct. All items showed an item-total correlation coefficient >0.4. Table 2 shows the univariate analysis of clinical factors associated with the IBD-Disk score. Hemoglobin level (p=0.973), serum albumin (p=0.998) and fecal calprotectin (p=0.183) were not associated with the IBD-Disk score. In multivariate analysis, a significant impact of the female sex (β=11.760 [6.117; 17.404], p<0.001), biological therapy (β=9.042 [1.546; 16.539], p=0.018) and perianal surgery (β=12.091 [2.862; 21.320], p=0.010) on the IBD-Disk total score was observed.
Conclusion
IBD-Disk is a valid and reliable tool for quantifying disability for both Crohn’s disease and ulcerative colitis in clinical practice. It should allow gastroenterologists to rapidly assess a patient’s disability at a given time.