IBDDI More Reliably Measures IBD-Related Disability Among Different Cultures Than Generic Tools

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Researchers compared the predictive properties of the IBDDI from among 5 populations of individuals living with IBD, most of whom had Crohn disease as well.

The inflammatory bowel disease (IBD) disability index (IBDDI) is a relatively new measure of IBD-related disability that is specific to the disease, making it a potentially more robust tool than current measures of disability, quality of life (QoL), and distress among essentially disparate populations of patients with IBD, according to a study in Clinical Gastroenterology and Hepatology.

Patients with IBD were invited to complete a self-administered survey comprising the IBDDI, the World Health Organization Disability Assessment Scale, the Work and Social Adjustment Scale, the IBD questionnaire, the Kessler-6 distress scale, and the Stanford presenteeism scale. These measures were used to assess disability, QoL, and distress.

The respondents to the survey included 1121 participants from Winnipeg, 511 from Chicago, 147 from Toronto, 97 from Hong Kong, and 96 from Jerusalem. Participants were recruited from registries, university medical centers, and IBD clinics. The investigators compared the correlation between IBDDI and the other 4 measures among sites. Additionally, the association between IBDDI and presenteeism and hospitalization in the past year was assessed.

A majority of participants in the survey study had Crohn disease, including 52% in Winnipeg, 64% in Chicago, 62% in Toronto, 65% in Hong Kong, and 77% in Jerusalem. The mean ages ranged from 35 years in Jerusalem to 51 years in Winnipeg. In addition, the mean disease duration ranged from 9 years in Jerusalem to 21 years in Winnipeg.

Although the mean IBDDI score varied among sites, there was a nearly identical correlation between IBDDI and each of the additional 4 measures of disability, QoL, and distress. Also, there was a nearly identical association between IBDDI and presenteeism in all sites. The association between hospitalization and high IBDDI was similar across sites.

Variables predictive of high IBDDI (≥35) including having Crohn disease vs ulcerative colitis or IBD-unclassified (odds ratio [OR], 1.3; 95% CI, 1.1-1.7; P =.012), being female (OR, 1.5; 95% CI, 1.2-1.8; P =.001), being recruited from the Hong Kong site (OR, 0.5; 95% CI, 0.3-0.9; P =.047), and admission to the hospital in the past year (OR, 3.2; 95% CI, 2.2-4.7; P <.001).

Limitations of this study were the lack of sites from economically disadvantaged countries and the recruitment of patients from mostly tertiary referral centers.

The investigators wrote of the IBDDI that its IBD-specific nature “sets it apart from the other tools and may make it a tool that can better discern the level of disability among people living with IBD.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Shafer LA, Sofia MA, Rubin DT, et al. An international multicentre comparison of IBD related disability and validation of the IBDDI [Published online August 25, 2020]. Clin Gastroenterol Hepatol. doi: 10.1016/j.cgh.2020.08.053