Feasibility of an 8‐item questionnaire for early diagnosis of inflammatory bowel disease in primary care

Abstract

Aims: Diagnosis of inflammatory bowel disease (IBD) is often associated with a diagnostic delay. Although faecal calprotectin is a helpful screening tool, the widespread use in primary care (PC) may not be appropriate due to the low prevalence of IBD in this setting. To increase pretest probability for a positive calprotectin test, an 8-item questionnaire (CalproQuest) was tested for its feasibility and acceptability in PC. Methods: Population: PC patients with unspecific gastrointestinal complaints for at least 2 weeks. The CalproQuest consists of four major and four minor questions specific for IBD. It is considered positive if greater than or equal to two major or one major and two minor criteria are positive. Primary outcome: feasibility of CalproQuest, secondary outcome: patient's acceptance of stool sampling.Results: Of 95 patients with a complete CalproQuest 52 (54.7%) were positive, 39 (41.1%) fulfilled two major and 13 (13.7%) one major and greater than or equal to two minor criteria. Twenty-seven general practitioners completed 83 (87.4%) questionnaires on feasibility which was assessed positive. Eighty-two patients (86.3%) completed questionnaires on acceptance which was high. Conclusion:The CalproQuest is a feasible instrument for assessing IBD in PC. Further prospective studies concerning validity and cost effectiveness of a combined use with the calprotectin test in this setting are necessary.

Prevalence and patient awareness of inflammatory bowel disease in Kazakhstan: a cross-sectional study

“…Since IBD could hugely impact on patients’ quality of life making them not to perform daily activities as mentioned above [ 3 , 4 ], the moderate to relatively severe IBD cases might not be captured in this study. However, to overcome these challenges and identify as many IBD cases as possible from the general population, we used an active case identification strategy, including colonoscopy with biopsy, the gold standard for IBD diagnosis as reported previously [ 7 , 8 , 31 ]. Moreover, we involved general physicians who can also have a piece of good knowledge about diagnosed and suspected IBD cases in their communities.…”

“…This cross-sectional study was carried out among subjects of both sexes aged 18 years and older using IBD Alert Questionnaire (CalproQuest) [ 7 ] from January 1 to December 31, 2017, across regions of Kazakhstan. IBD Alert Questionnaire has been tested and found practicable in primary care [ 8 ]. The questionnaires were distributed both electronically and in hard copy (details below).…”

“…IBD case identification was done by the following steps. The first step consisted of an active IBD case identification among the adult population through the questionnaire proposed by Hasler et al [ 7 , 8 ]. The second step was the examination of the suspected cases with positive symptoms by a qualified gastroenterologist who also performed a FCAL test [ 9 ] by a semi-quantitative method (PreventID ® CalDetect ® 50/200; Preventis GmbH, Bensheim, Germany).…”

“…However, to overcome these challenges and identify as many IBD cases as possible from the general population, we used an active case identification strategy, including colonoscopy with biopsy, the gold standard for IBD diagnosis as reported previously. 7,8,31 Moreover, we involved general physicians who can also have a piece of good knowledge about diagnosed and suspected IBD cases in their communities. Another limitation is since the large geographical spread of rural areas in Kazakhstan, unavailability of appropriate gastroenterological care in it and the limited financial resources, rural residents were partially underrepresented, specifically remote rural residents.…”

Can the CalproQuest predict a positive Calprotectin test? A prospective diagnostic study

“…To increase pretest-probability for a positive test result of the fecal Calprotectin test aiming at diagnosing IBD in an earlier stage, we developed an 8-item-questionnaire: the CalproQuest [19]. The CalproQuest has been shown to be a feasible instrument for the assessment of IBD in PC, but has not yet been evaluated clinically [20]. This study aims to prospectively validate the CalproQuest concerning sensitivity and specificity for positive fecal Calprotectin test results and positive IBD diagnosis.…”