Cutoff values of the Inflammatory Bowel Disease Questionnaire to predict a normal health related quality of life.

UNLABELLED: One of the objectives in the treatment of the inflammatory bowel disease (IBD) is improving the patient's quality of life. However, we do not dispose of validated criteria to determine the questionnaire's scoring threshold that has to be reached in order to be able to assert that the patients' quality of life has normalized. OBJECTIVE: To determine the normality punctuation cutoff in the IBD specific quality of life questionnaire IBDQ-36. METHOD: Cross-sectional study in a random sample of IBD patients, who have completed the questionnaires IBDQ-36 and EuroQol-5D. The IBDQ-36 normality was calculated according to its equivalence with the EuroQol-5D tariff ≥ 0.90, which corresponds to the 95% CI of the average obtained in a Spanish general population. RESULTS: 218 patients were included. According to the EuroQol-5D tariff, 70 patients were considered to have a normal quality of life and 148 a quality of life poorer than the general population. The IBDQ-36 scoring was significantly higher in the normal quality of life group (222.9 ± 22.8 vs. 171.4 ± 44.8 in the bad quality of life group, p<0.001). According to the linear regression between IBDQ-36 and EuroQol-5D, the cutoff point is 209, with a sensitivity and specificity to predict normality of 0.74 and 0.71 respectively. CONCLUSIONS: Scores of the IBDQ-36 equal or superior to 209 suggest quality of life comparable to that perceived by the general population. This study allowed to set a threshold of normality in the management of the inflammatory bowel diseases.

[Spanish translation, adaptation, and validation of the 32-item questionnaire on quality of life for inflammatory bowel disease(IBDQ-32)]. / Traducción, adaptación y validación al español del cuestionario de calidad de vida de 32 ítems (IBDQ-32) de la enfermedad inflamatoria intestinal.

INTRODUCTION: The measurement of health-related quality of life (HRQoL) has an established relevance in the assessment, management, and follow-up of inflammatory bowel disease. The most commonly used measuring instrument is the 32-item version of Inflammatory Bowel Disease Questionnaire (IBDQ-32), which has never been adapted to Spanish. OBJECTIVE: To translate IBDQ-32 into Spanish, and to establish its validity, reliability, and sensitivity both in ulcerative colitis and Crohn s disease. METHOD: A prospective study in two phases -translation into Spanish and subsequent validation of IBDQ-32. Translation was based on the validated Spanish version of IBDQ-36, and IBDQ-32 items not included in IBDQ-36 were translated from scratch. Once the IBDQ32 translation was completed a comprehension-specific questionnaire was administered. To establish IBDQ-32 psychometric properties a group of patients completed both the validated Spanish version of IBDQ-36 and IBDQ-32. RESULTS: Eighty-four patients (53 with Crohn s disease and 31 with ulcerative colitis) were included. Median overall scores in both questionnaires for all 84 patients did not differ (6.1 vs. 6.2, p = ns), and Spearman s correlation was highly significant (r = 0.97, p < 0.001). The ability to discriminate between patients in flare-up or remission was also equivalent for both questionnaires (6.4 vs. 6.4 with r = 0.96 in remission and 3.8 vs. 3.9 with r = 0.95 active, p < 0.001 for remission vs. activity). These results were obtained in both the analyses for CD and UC independently (6.4 vs. 6.4 and 6.7 vs. 6.6, respectively; p = ns). CONCLUSION: The Spanish version of IBDQ-32 is valid and discriminating for patients with Crohn s disease or ulcerative colitis.

[Inflammatory bowel disease in celiac patients]. / Enfermedad inflamatoria intestinal en pacientes celíacos.

INTRODUCTION: A potential association between celic disease and inflammatory bowel disease hs been suggested, which may explain the fact that both disorders occasionally present in one patient or in his/her first-degree relatives more frequently than expected. OBJECTIVE: To establish the prevalence of Crohn s disease and ulcerative colitis in celiac patients and their relatives. METHOD: A cross-sectional, prospective epidemiological study in a group of celiac patients, their first-degree relatives, and a control group with similar epidemiological characteristics including the relatives of patients presenting at the ER for acute conditions. A semistructured interview was used to identify the presence of Crohn s disease and ulcerative colitis in celiac patients and their relatives. RESULTS: In all, 86 celiac patients and 432 relatives were included, who were compared to 809 control subjects (129 patients with acute conditions and 680 first-degree relatives). Three cases of Crohn s disease were identified among celiac patients, and 4 cases among their relatives. Only 1 case of Crohn s disease was detected in the control group (p < 0.01). No cases of ulcerative colitis were detected in any of the study groups. CONCLUSION: Patients with celiac disease and their relatives have a greater predisposition to Crohn s disease versus the control population.

Traducción, adaptación y validación al español del cuestionario de calidad de vida de 32 ítems (IBDQ-32) de la enfermedad inflamatoria intestinal / Spanish translation, adaptation, and validation of the 32-item quality of life questionnaire (IBDQ-32) for inflammatory bowel disease

Introducción: la medida de la calidad de vida relacionada conla salud (CVRS) tiene una reconocida importancia en la evaluación,el manejo y el seguimiento de la enfermedad inflamatoria intestinal.El instrumento de medida más utilizado es la versión de32 ítems del Inflammatory Bowel Disease Questionnaire (IBDQ-32), que no está adaptado al español.Objetivo: traducir la versión del IBDQ-32 al español y determinarsu validez, fiabilidad y sensibilidad tanto en la colitis ulcerosacomo en la enfermedad de Crohn.Método: estudio prospectivo en dos fases: traducción y posteriorvalidación del IBDQ-32 al español. La traducción se ha basadoen la versión al español validada del IBDQ-36, y los ítems delIBDQ-32 no incluidos en el IBDQ-36 se tradujeron “de novo”.Una vez terminada la traducción del IBDQ32, se aplicó un cuestionarioespecífico de comprensión. Para determinar las propiedadespsicométricas del IBDQ-32, un grupo de pacientes completóel IBDQ-36 ya validado al español y el IBDQ-32.Resultados: se han incluido 84 pacientes (53 con enfermedadde Crohn y 31 con colitis ulcerosa). La mediana de la puntuaciónglobal de ambos cuestionarios en los 84 pacientes no fue diferente(6,1 vs. 6,2, p = ns) y su correlación de Spearman fue muy significativa(r = 0,97, p < 0,001). La capacidad de discriminar entre pacientescon brote y remisión también fue equivalente en amboscuestionarios (6,4 vs. 6,4 con r = 0,96 en remisión y 3,8 vs. 3,9con r = 0,95 en actividad, p < 0,001 remisión vs actividad). Estosresultados se reprodujeron en el análisis para EC y CU independientemente(6,4 vs. 6,4 y 6,7 vs. 6,6 respectivamente, p = ns).Conclusión: la versión en castellano de 32 ítems del IBDQ esválida y discriminativa para ser aplicada en pacientes con enfermedadde Crohn o colitis ulcerosa

Introduction: the measurement of health-related quality oflife (HRQoL) has an established relevance in the assessment,management, and follow-up of inflammatory bowel disease. Themost commonly used measuring instrument is the 32-item versionof Inflammatory Bowel Disease Questionnaire (IBDQ-32), whichhas never been adapted to Spanish.Objective: to translate IBDQ-32 into Spanish, and to establishits validity, reliability, and sensitivity both in ulcerative colitisand Crohn’s disease.Method: a prospective study in two phases –translation intoSpanish and subsequent validation of IBDQ-32. Translation wasbased on the validated Spanish version of IBDQ-36, and IBDQ-32 items not included in IBDQ-36 were translated from scratch.Once the IBDQ32 translation was completed a comprehensionspecificquestionnaire was administered. To establish IBDQ-32psychometric properties a group of patients completed both thevalidated Spanish version of IBDQ-36 and IBDQ-32.Results: eighty-four patients (53 with Crohn’s disease and 31with ulcerative colitis) were included. Median overall scores inboth questionnaires for all 84 patients did not differ (6.1 vs. 6.2,p = ns), and Spearman’s correlation was highly significant (r =0.97, p < 0.001). The ability to discriminate between patients inflare-up or remission was also equivalent for both questionnaires(6.4 vs. 6.4 with r = 0.96 in remission and 3.8 vs. 3.9 with r =0.95 active, p < 0.001 for remission vs. activity). These resultswere obtained in both the analyses for CD and UC independently(6.4 vs. 6.4 and 6.7 vs. 6.6, respectively; p = ns).Conclusion: the Spanish version of IBDQ-32 is valid and discriminatingfor patients with Crohn’s disease or ulcerative colitis (AU)

Enfermedad inflamatoria intestinal en pacientes celíacos / Inflammatory bowel disease in celiac patients

Introducción: se ha sugerido una potencial asociación entrela enfermedad celíaca y la enfermedad inflamatoria intestinal, quepuede justificar que ambas enfermedades puedan presentarse enun mismo enfermo o en sus familiares de primer orden con mayorfrecuencia de lo esperado.Objetivo: determinar la prevalencia de la enfermedad deCrohn y la colitis ulcerosa en los enfermos celíacos y en sus familiares.Método: estudio epidemiológico prospectivo transversal en ungrupo de pacientes celíacos, sus familiares de primer grado y ungrupo control de características epidemiológicas similares, constituidopor familiares de pacientes que acuden al Servicio de Urgenciaspor un problema agudo. Para detectar la existencia de colitisulcerosa y enfermedad de Crohn en los celíacos y sus familiares,se realizó una entrevista semiestructurada.Resultados: se han incluido 86 celíacos y 432 familiares, quese han comparado con 809 controles (129 pacientes con una enfermedadaguda y 680 familiares de primer grado suyos). Se handetectado 3 casos de enfermedad de Crohn en el grupo de los enfermoscelíacos y 4 casos de enfermedad de Crohn en sus familiares.Sólo se ha detectado 1 caso de enfermedad de Crohn en elgrupo control (p < 0,01). No se ha identificado ningún caso decolitis ulcerosa en ninguno de los tres grupos de estudio.Conclusión: los pacientes con enfermedad celíaca y sus familiarestienen mayor predisposición a presentar una enfermedad deCrohn, que la población control

Introduction: a potential association between celic diseaseand inflammatory bowel disease hs been suggested, which mayexplain the fact that both disorders occasionally present in onepatient or in his/her first-degree relatives more frequently than expected.Objective: to establish the prevalence of Crohn’s disease andulcerative colitis in celiac patients and their relatives.Method: a cross-sectional, prospective epidemiological studyin a group of celiac patients, their first-degree relatives, and a controlgroup with similar epidemiological characteristics includingthe relatives of patients presenting at the ER for acute conditions.A semistructured interview was used to identify the presence ofCrohn’s disease and ulcerative colitis in celiac patients and theirrelatives.Results: in all, 86 celiac patients and 432 relatives were included,who were compared to 809 control subjects (129 patientswith acute conditions and 680 first-degree relatives). Three casesof Crohn’s disease were identified among celiac patients, and 4cases among their relatives. Only 1 case of Crohn’s disease wasdetected in the control group (p < 0.01). No cases of ulcerativecolitis were detected in any of the study groups.Conclusion: patients with celiac disease and their relativeshave a greater predisposition to Crohn’s disease versus the controlpopulation (AU)