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P248 Validation of IBD-disk for the assessment of daily-life burden of patients with inflammatory bowel disease

S. Tadbiri1, M. Nachury2, Y. Bouhnik3, M. Serrero4, F. Jerome5, X. Roblin6, A. Bourrier7, G. Bouguen8, D. Franchimont9, G. Savoye10, A. Buisson11, E. Louis12, S. Nancey13, V. Abtibol14, J.M. Reimund15, O. DeWitt16, L. Vuitton17, N. Matthieu18, L. Peyrin-Biroulet19, C. Gilletta20, M. Allez21, S. Viennot22, A. Bourreille23, N. Dib24, H. Brixi25, M. Boualit26, L. Plastaras27, R. Altwegg28, M. Fumery29, L. Caillo30, D. Laharie31, A. Amiot2

1GETAID: Henri Mondor Hospital, Paris Est Creteil University, Department of Gastroenterology, Creteil Cedex, France, 2Huriez Hospital, Gastroenterology, Lille, France, 3Beaujon University Hospital, Gastroenterology- IBD and Nutrition Support, Clichy, France, 4Hopital Nord, Gastroenterology, Marseille, France, 5Nice University Hospital, Gastroenterology, Nice, France, 6Saint Etienne University Hospital, Gastroenterology, Saint Etienne, France, 7Saint Antoine University Hospital, Gastroenterology, Paris, France, 8Rennes University Hospital, Gastroenterology, Rennes, France, 9Erasme University Hospital, Gastroenterology, Bruxelles, Belgium, 10Rouen University Hospital, Gastroenterology, Rouen, France, 11Clermont Ferrand University Hospital, Gastroenterology, Clermont-Ferrand, France, 12Liege University Hospital, Gastroenterology, Liege, Belgium, 13Hospices Civils de Lyon, Gastroenterology, Lyon, France, 14Cochin University Hospital, Gastroenterology, Paris, France, 15Strasbourg University Hospital, Gastroenterology, Strasbourg, France, 16Cliniques Universitaires Saint Luc, Gastroenterology, Bruxelles, Belgium, 17Besnacon University Hospital, Gastroenterology, Besancon, France, 18Grenoble University Hospital, Gastroenterology, Grenoble, France, 19Nancy University Hospital, Gastroenterology, Nancy, France, 20Toulouse, University Hospital, Gastroenterology, France, 21Saint Louis University Hospital, Gastroenterology, Paris, France, 22Caen university Hospital, Gastroenterology, Caen, France, 23Nantes University Hospital, Gastroenterology, Nantes, France, 24Angers University Hospital, Gastroenterology, Angers, France, 25Reims University Hospital, Gastroenterology, Reims, France, 26Valenciennes General Hospital, Gastroenterology, Valenciennes, France, 27Colmar General Hospital, Gastroenterology, COlmar, France, 28Montpellier University Hospital, Gastroenterology, Montpellier, France, 29Amiens University Hospital, Gastroenterology, AMiens, France, 30Nimes University Hospital, Gastroenterology, Nimes, France, 31Bordeaux University Hospital, Gastroenterology, Bordeaux, France

Background

The IBD-disk is a 10-item visual tool assessing inflammatory bowel diseases (IBD)-related disability. It could be a valuable tool in daily practice but it has not been validated. In a cohort of patients with IBD, we aimed to determine the correlation between the IBD-disk and each of its components with the IBD daily-life burden.

Methods

A 1-week cross-sectional study has been conducted in 42 centres affiliated to the GETAID in France and Belgium in November 2018. Patients were asked to fulfil the IBD-disk questionnaire and an IBD daily-life burden visual analogic scale (VAS: 0 = no burden; 10 = maximal burden). The validation included for internal consistency, correlation analysis and diagnostic performance assessment. In addition, we evaluated the completion rate as well as patient satisfaction for IBD-disk. Multivariate analysis was performed to determine predictors of moderate-to-severe IBD-related disability.

Results

Among the 2011 IBD outpatients who responded to the survey (67.8% of patients with Crohn’s disease), 49.9% were in clinical remission. The full completion rate of the IBD-disk was 73.8%. It was considered easy to fulfil by 88.4% of patients. The mean IBD-disk score was 39.0 ± 23.2 (best score 0, worst 100). The IBD-disk score was well correlated with IBD daily-life burden VAS (r = 0.62; p < 0.001). With the optimal IBD-disk cut-off of 40, AUROC for high IBD daily-life burden was 0.81 (CI95%: 0.79–0.83; p < 0.001). Using multiple logistic regression, a shortened IBD-disk score using only 5 items (abdominal pain + regulating defecation x2 + work and education x3 + emotions + energy) of the IBD-disk had similar correlation and diagnosis performance than the complete IBD-disk score (AUROC=0.82 [0.79–0.83]; p < 0.001) for assessing IBD daily-life burden. In multivariate analysis, moderate-to-severe disability (overall IBD-disk score > 40) was significantly increased in patients with frequent sick leave > 0.3 per year, with general practitioner appointment > 2 per year, with concerns about the lack of efficacy of their current treatment, perceived need of psychotherapist or IBD-nurse whereas it was decreased in patients with clinical remission assessed by patient global assessment and employed or student occupational status.

Conclusion

The IBD-disk had a good completion rate and demonstrated a close correlation with daily-life IBD burden and good internal consistency, in a large multicentre cohort of IBD patients. Our results suggest that the IBD-disk could be a valuable tool in routine practice to assess daily-life IBD burden. Although a simplified 5-item IBD-disk demonstrated better performance to assess IBDdaily-life burden, the overall score, the IBD-disk allows exploring all dimensions of IBD daily-life burden.