Assessment of factors affecting disability in inflammatory bowel disease and the reliability of the Inflammatory Bowel Disease Disability Index
Alimentary Pharmacology and Therapeutics | Oct 13, 2017
Lo B, et al. - This meta-analysis was performed to evaluate the severity of disability and associated factors using the Inflammatory Bowel Disease Disability Index (IBD-DI) and examine the validity of the IBD-DI as a tool. In this systematic review, the researchers found a significant relationship between disease activity, treatment received and disability, although significant heterogeneity was found. As per findings, the IBD-DI was reliable and valid. However, to measure its interpretability, further studies were required.
Methods- The researchers performed a systematic review of cross-sectional studies.
- Patients who had Crohn's disease (CD) and ulcerative colitis (UC) were included and classified as active, in remission, or needing surgery, biological and/or steroid treatment.
- Using the IBD-DI, they included studies assessing disability.
- The studies were captured by electronic and manual searches (January 2017).
- They evaluated the possibility of bias with the Newcastle-Ottawa Scale.
- The researchers included 9 studies with 3167 patients.
- Patients with active disease had higher disability rates than those in remission (SMD [CI95] = 1.49[1.11, 1.88], I2 = 94%, P<.01).
- In comparison, patients on biological treatment had lower disability rates than those receiving corticosteroid treatment (SMD [CI95] = -0.22[-0.36, -0.08], I2 = 0%, P<.01).
- In this study, disease activity and unemployment were found to be associated factors.
- For internal consistency, the IBD-DI scored ÂgoodÂ, for intra-rater reliability Âfair to Âexcellent and for inter-rater reliability ÂexcellentÂ.
- Construct validity was Âmoderately strong to Âvery strong and structural validity was seen to be mainly unidimensional.
- While its interpretability was only useful on a group level, the IBD-DI had excellent responsiveness.
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