The DETection of Arthritis in Inflammatory boweL diseases (DETAIL) questionnaire: development and preliminary testing of a new tool to screen patients with inflammatory bowel disease for the presence of spondyloarthritis

Carlo, Marco Di; Luchetti, Michele Maria; Benfaremo, Devis; Donato, Eleonora Di; Mosca, Piergiorgio; Maltoni, S.; Benedetti, Antonio; Gabrielli, Armando; Grassi, Walter; Salaffi, Fausto

doi:10.1007/s10067-017-3937-6

Cited by 30 publications

(22 citation statements)

References 24 publications

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“…Recently, several red flags have been proposed to facilitate early referral of patients with Crohn's disease from primary to specialist care and thus avoid diagnostic delay . Moreover, a six‐item questionnaire (DETAIL) has been developed to screen patients with IBD for the diagnosis of SpA, but it needs to be validated in larger cohorts of patients .…”

Section: Introductionmentioning

confidence: 99%

Red flags for appropriate referral to the gastroenterologist and the rheumatologist of patients with inflammatory bowel disease and spondyloarthritis

Felice

Leccese

Scudeller

et al. 2019

Clinical and Experimental Immunology

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Collaboration between gastroenterologists and rheumatologists is recommended for the correct management of patients with associated spondyloarthritis (SpA) and inflammatory bowel disease (IBD). We aimed to establish the appropriateness of several red flags for a prompt specialist referral. A systematic review of the literature was performed using the GRADE method to describe the prevalence of co-existing IBD-SpA and the diagnostic accuracy of red flags proposed by a steering committee. Then, a consensus among expert gastroenterologists and rheumatologists (10 in the steering committee and 13 in the expert panel) was obtained using the RAND method to confirm the appropriateness of each red flag as 'major' (one sufficient for patient referral) or 'minor' (at least three needed for patient referral) criteria for specialist referral. The review of the literature confirmed the high prevalence of co-existing IBD-SpA. Positive and negative predictive values of red flags were not calculated, given the lack of available data. A consensus among gastroenterology and rheumatology specialists was used to confirm the appropriateness of each red flag. Major criteria to refer patients with SpA to the gastroenterologist included: rectal bleeding, chronic abdominal pain, perianal fistula or abscess, chronic diarrhoea and nocturnal symptoms. Major criteria to refer patients with IBD to the rheumatologist included: chronic low back pain, dactylitis, enthesitis and pain/swelling of peripheral joints. Several major and minor red flags have been identified for the diagnosis of co-existing IBD-SpA. The use of red flags in routine clinical practice may avoid diagnostic delay and reduce clinic overload.

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Section: Introductionmentioning

confidence: 99%

Red flags for appropriate referral to the gastroenterologist and the rheumatologist of patients with inflammatory bowel disease and spondyloarthritis

Felice

Leccese

Scudeller

et al. 2019

Clinical and Experimental Immunology

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“…Among the 14 CD patients with sacroiliitis, 11 patients completed the self-administrated questionnaire for detecting arthritis in IBD patients (Korean version of DETAIL) [21]. All of them denied inflammatory back pain, so they were considered having subclinical sacroiliitis.…”

Section: Associations Of Sacroiliitis With Clinical Features Of CDmentioning

confidence: 99%

“…Firstly, because of its retrospective nature of our study, information about SpA symptoms was not systematically collected and dependent on the medical chart review. However, 11 of the 14 patients with sacroiliitis completed the DETAIL questionnaire [21], which can detect symptoms suggesting SpA, and the remaining three [39], was only available in a small number of patients, so an analysis about the association between sacroiliitis and clinical activity of CD was limited. Finally, due to the retrospective nature of the study, the CT image were acquired with various CT scanners and the image quality varied.…”

Section: A C C E P T E D a R T I C L Ementioning

confidence: 99%

Subclinical sacroiliitis detected by abdominopelvic computed tomography in Korean patients with Crohn’s disease

Kim

Lee

et al. 2020

Korean J Intern Med

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Background/Aims: Sacroiliitis is a frequent extraintestinal manifestation of inflammatory bowel diseases (IBD). This study aimed to assess the prevalence of sacroiliitis using a validated screening tool based on abdominopelvic computed tomography (APCT) in Korean patients with Crohn's disease (CD) and examine potential associations between clinical characteristics and sacroiliitis. Methods: One hundred five patients with CD undergoing APCT for any indication at an IBD clinic were matched 1:1 for age and sex with 105 controls without underlying chronic illnesses. Using a validated APCT screening tool that defines sacroiliitis as either ankylosis or a total erosion score (TES) ≥ 3, all CT scans were assessed by two independent, blinded radiologists. We compared the prevalence of sacroiliitis between CD patients and controls and clinical characteristics between CD patients with and without sacroiliitis. Results: The prevalence of sacroiliitis was significantly higher in CD patients than in controls (13.3 % vs. 4.8 %, p = 0.030). All subjects with sacroiliitis had a TES ≥ 3, but no ankylosis. The assessment of sacroiliitis in APCT showed excellent interreader reliability (Cohen's kappa = 0.933 for presence of sacroiliitis). Sacroiliitis in CD patients was bilateral and asymptomatic. There were no significant associations between sacroiliitis and any demographic data or clinical characteristics in these patients. Conclusion: The prevalence of APCT-detected sacroiliitis in CD patients was higher than that in controls, but the condition was asymptomatic. The clinical significance of asymptomatic sacroiliitis in Korean CD patients remains unclear.

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“…The number of questionnaires studied to find the SpA in IBD is fairly limited [7][8][9][10][11][12], as well as the number of studies that have search for which IBD patients are at increased risk of associated arthropathy [2,13]: only three studies specifically developed a questionnaire to find SpA in IBD and none correlated the findings with immunosuppressants or biologics use.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of suspected spondyloarthritis among inflammatory bowel disease patients

Ribaldone

Vernero

Parisi

et al. 2019

Scandinavian Journal of Gastroenterology

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Background: Occurring in approximately 20 to 30% of patients, spondyloarthritis is the most common extraintestinal manifestation in inflammatory bowel disease (IBD). Aims: To look for risk factors of spondyloarthritis among inflammatory bowel disease patients. Methods: We modified the STRIPP questionnaire created for psoriatic patients and we created a rapid questionnaire for rheumatologic investigation in IBD patients (STRII). We submitted the questionnaire to all consecutive patients with a known spondyloarthritis in our centre and to patients with a negative rheumatological diagnosis to find the cutoff value. Finally, we prospectively submitted the STRII questionnaire to all consecutive IBD patients in our centre. Results: A cutoff >= 3 correlated with spondyloarthritis with an AUC = 0.91. The STRII questionnaire was submitted to 1147 IBD patients. Two hundred and forty-four out of 1147 (21.3%) collected a STRII score of >= 3. Female sex (p < 0.0001) and Crohn's disease (p = 0.023) were risk factors. Patients with a history of at least 1 immunosuppressant or biologic drug (p = 0.002 and p < 0.0001, respectively) had a higher rate of positivity to STRII questionnaire. Conclusion: Among IBD patients, females, Crohn's disease, those with an history of at least 1 immunosuppressive or biological therapy are at increased risk of spondyloarthritis.

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The DETection of Arthritis in Inflammatory boweL diseases (DETAIL) questionnaire: development and preliminary testing of a new tool to screen patients with inflammatory bowel disease for the presence of spondyloarthritis

Cited by 30 publications

References 24 publications

Red flags for appropriate referral to the gastroenterologist and the rheumatologist of patients with inflammatory bowel disease and spondyloarthritis

Red flags for appropriate referral to the gastroenterologist and the rheumatologist of patients with inflammatory bowel disease and spondyloarthritis

Subclinical sacroiliitis detected by abdominopelvic computed tomography in Korean patients with Crohn’s disease

Risk factors of suspected spondyloarthritis among inflammatory bowel disease patients

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