VALIDation of the IBD-Disk Instrument for Assessing Disability in Inflammatory Bowel Diseases in a French Cohort: The VALIDate Study

J Crohns Colitis. 2020 May 17;jjaa100. doi: 10.1093/ecco-jcc/jjaa100. Online ahead of print.

Catherine Le Berre 1, Mathurin Flamant 1 2, Guillaume Bouguen 3, Laurent Siproudhis 3, Marie Dewitte 3, Nina Dib 4, Elodie Cesbron-Metivier 4, Thomas Goronflot 5, Matthieu Hanf 5, Pierre-Antoine Gourraud 5, Elise Kerdreux 2, Alexandra Poinas 6, Arnaud Bourreille 1 2, Caroline Trang-Poisson 1 2


Author information

1Institut des Maladies de l'Appareil Digestif, Nantes University Hospital, Nantes, France.

2Centre d'Investigation Clinique, Nantes University Hospital, Nantes, France.

3Service des Maladies de l'Appareil Digestif, Rennes University Hospital, Rennes, France.

4Service de Gastroentérologie, Angers University Hospital, Angers, France.

5Clinique des Données, Nantes University Hospital, Nantes, France.

6Direction de la Recherche Clinique, Nantes University Hospital, Nantes, France.


Background and aims: Inflammatory bowel diseases (IBD) are disabling disorders. The IBD-Disability Index (IBD-DI) was developed for quantifying disability in IBD patients but is difficult to use. The IBD-Disk is a visual adaptation of the IBD-DI. It has not been validated yet. The main objectives were to validate the IBD-Disk, to assess the clinical factors associated with a change in the score and its variability over time.

Methods: From May 2018 to July 2019, IBD patients from three university-affiliated hospitals responded twice to both IBD-Disk and IBD-DI at 3-12 months intervals. Validation included concurrent validity, reproducibility, and internal consistency. Mean IBD-Disk scores were compared according to clinical factors. Variability was assessed by comparing scores between baseline and follow-up visits.

Results: A total of 447 patients (71% Crohn's disease, 28% ulcerative colitis) were included in the analysis at baseline and 265 at follow-up. There was a good correlation between IBD-Disk and IBD-DI (r = 0.75, p <0.001). Reproducibility was excellent (intra-class correlation coefficient = 0.90), as well as internal consistency (Cronbach's α = 0.89). The IBD-Disk was not influenced by IBD type but was associated with female gender and physician global assessment. Extra-intestinal manifestations, history of resection, elevated CRP and fecal calprotectin also tended to be associated with higher disability. The IBD-Disk score decreased in patients becoming inactive over time.

Conclusions: This study validated the IBD-Disk in a large cohort of IBD patients, demonstrating that it is a valid and reliable tool for quantifying disability for both CD and UC.

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