PMO-242 The IBD-control questionnaire: development and psychometric validation of a tool for capturing disease control from the patient perspective for use in routine care
Bibliographic record
Abstract
Introduction Although a range of disease activity measures and QoL questionnaires is available for IBD, none has found a place in routine clinical practice. This project aimed to develop a tool for capturing disease control from the patient's perspective with measurement properties appropriate for routine clinical practice. Methods Phase I : Systematic review of existing PROMS, patient focus groups and a steering group to define domains and items for the “ IBD-Control ”. Instrument comprises 13 questions items plus a visual analogue scale (VAS, 0–100) for overall control. Phase II : Prospective validation, patient completion of IBD-Control, QoL questionnaire (UK-IBD-Q), EuroQol (EQ5D), Hospital Anxiety & Depression Score (HADS); clinician assessment (blinded to questionnaire) recording disease activity (Harvey Bradshaw Index, HBI; or Simple Clinical Colitis Activity Index, SCCAI), global clinician assessment (remission; mild; moderate; severe), Montreal Classification, treatment history. Ongoing longitudinal survey (serial questionnaires). Results 194/200 returned baseline surveys (CD, n=107; UC, n=87). Study population (CD, UC): Age (mean): 41; 48 yrs. Disease duration (mean): 10.5; 10.7 yrs. Prev. Surgery (%): 50%; 3.4%. Immunosuppressants (%): 49.5%; 27.6%. Biologics (%): 22.4%; 8.0%. Disease activity (mean [SD] HBI; SCCAI): 5 [5]; 4 [3]. Measurement properties of IBD-Control: Completion time (mean [SD]): 1 min 15 s [25s]; Internal consistency: Cronbach's α for all 13 items: 0.838; for sub-group of 8 questions (IBD-Control-8): 0.841. Strong correlation between IBD-Control-8 sub-score and IBD-Control-VAS (r=0.79). Test-retest reliability for stable patients (Baseline vs 2 week repeat, no change): IBD-Control-8, 15.8 vs 15.6; p=0.73; IBD-Control-VAS, 65.5 vs 68.0, p=0.33. Validity: Moderate-to-strong correlations between IBD-Control-8 subscore and IBD-Control-VAS vs disease activity, UK-IBD-Q and global health state (utility) with r values 0.56 to 0.84. Discriminant validity (mean scores for remission, mild, moderate, severe): ANOVA p<0.01. Sensitivity to change: (analysis of first 53 follow-ups): No significant changes for stable patients; moderate-to-large responsiveness statistics for IBD-Control-8 and IBD-Control-VAS: (Effect sizes: 0.4–1.6). Conclusion The IBD-Control shows promise as a rapid (<2 min), reliable, valid and sensitive instrument for measuring overall disease control from the patients perspective. Unlike existing PROMS, its ease-of-use and generic applicability make it a candidate for use in routine practice as a decision-support tool for patients and clinicians. Competing interests C Ormerod: None declared, D Shackcloth: Grant/Research Support from: Abbott Laboratories Ltd, M Harrison: None declared, E Brown: None declared, K Bodger: Grant/Research Support from: Abbott Laboratories Ltd.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.021 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".