Khalid A Alnaqbi1, Zahi Touma, Laura Passalent, Sindhu R Johnson, George A Tomlinson, Adele Carty, Robert D Inman. 1. From the Department of Medicine, Division of Rheumatology, University of Toronto, Toronto Western Hospital, Toronto; Al Ain Hospital, Medical Institute, Al Ain, United Arab Emirates; and Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: There is an unacceptable delay in the diagnosis of axial spondyloarthritis (axSpA) in its early stages among patients at high risk, in particular those with inflammatory bowel disease (IBD). Our objectives were to develop a sensible and reliable questionnaire to identify undetected axSpA among patients with IBD. METHODS: Literature was reviewed for item generation in the Toronto axSpA Questionnaire on IBD (TASQ-IBD). Sensibility of the questionnaire was assessed among healthcare professionals and patients. This assessment was related to purpose and framework (clinical function, clinical justification, and clinical applicability), face validity, comprehensiveness [oligo-variability (limiting the questionnaire to important items) and transparency], replicability, content validity, and feasibility. The test-retest reliability study was administered to 77 patients with established IBD and axSpA. Kappa agreement coefficients and absolute agreement were calculated for items. RESULTS: Three domains included IBD, inflammatory back symptoms, and extraaxial features. The entry criterion required a patient to have IBD and back pain or stiffness that ever persisted for ≥ 3 months. Iterative sensibility assessment involved 16 items and a diagram of the back. Kappa coefficients ranged from 0.81-1.00 for each item. Absolute agreement across all items ranged from 91% to 100%. CONCLUSION: TASQ-IBD is a newly developed, sensible, and reliable case-finding questionnaire to be administered to patients with IBD who have ever had chronic back pain or stiffness persisting for ≥ 3 months. It should facilitate identification and timely referral of patients with IBD to rheumatologists and minimize the delay in diagnosis of axSpA. Consequently, it should assess the prevalence of axSpA in IBD.
OBJECTIVE: There is an unacceptable delay in the diagnosis of axial spondyloarthritis (axSpA) in its early stages among patients at high risk, in particular those with inflammatory bowel disease (IBD). Our objectives were to develop a sensible and reliable questionnaire to identify undetected axSpA among patients with IBD. METHODS: Literature was reviewed for item generation in the Toronto axSpA Questionnaire on IBD (TASQ-IBD). Sensibility of the questionnaire was assessed among healthcare professionals and patients. This assessment was related to purpose and framework (clinical function, clinical justification, and clinical applicability), face validity, comprehensiveness [oligo-variability (limiting the questionnaire to important items) and transparency], replicability, content validity, and feasibility. The test-retest reliability study was administered to 77 patients with established IBD and axSpA. Kappa agreement coefficients and absolute agreement were calculated for items. RESULTS: Three domains included IBD, inflammatory back symptoms, and extraaxial features. The entry criterion required a patient to have IBD and back pain or stiffness that ever persisted for ≥ 3 months. Iterative sensibility assessment involved 16 items and a diagram of the back. Kappa coefficients ranged from 0.81-1.00 for each item. Absolute agreement across all items ranged from 91% to 100%. CONCLUSION: TASQ-IBD is a newly developed, sensible, and reliable case-finding questionnaire to be administered to patients with IBD who have ever had chronic back pain or stiffness persisting for ≥ 3 months. It should facilitate identification and timely referral of patients with IBD to rheumatologists and minimize the delay in diagnosis of axSpA. Consequently, it should assess the prevalence of axSpA in IBD.
Authors: Mohamed Attauabi; Gorm Roager Madsen; Flemming Bendtsen; Anne Vibeke Wewer; Rune Wilkens; Johan Ilvemark; Nora Vladimirova; Annette Bøjer Jensen; Frank Krieger Jensen; Sanja Bay Hansen; Hartwig Roman Siebner; Yousef Jesper Wirenfeldt Nielsen; Jakob M Møller; Henrik S Thomsen; Simon Francis Thomsen; Helene Andrea Sinclair Ingels; Klaus Theede; Trine Boysen; Jacob T Bjerrum; Christian Jakobsen; Maria Dorn-Rasmussen; Sabine Jansson; Yiqiu Yao; Ewa Anna Burian; Frederik Trier Møller; Viktoria Fana; Charlotte Wiell; Lene Terslev; Mikkel Østergaard; Kristina Bertl; Andreas Stavropoulos; Jakob B Seidelin; Johan Burisch Journal: BMJ Open Date: 2022-06-27 Impact factor: 3.006