P0240 Cross-cultural adaptation and validation of the Crohn’s Anal Fistula – Quality of Life scale in Dutch patients with active perianal fistulizing Crohn’s disease
Bibliographic record
Abstract
Abstract Background Perianal fistulizing Crohn’s disease (pCD) is associated with debilitating symptoms such as fecal incontinence and perianal pain, and can significantly impact a patient’s quality of life (QoL)1. The Crohn’s Anal Fistula Quality of Life (CAF-QoL) scale has recently been developed as the first disease-specific patient-reported outcome measure for patients with pCD2, but has yet to be validated in an independent cohort. Therefore, we aimed to adapt and validate the CAF-QoL scale in a Dutch cohort of patients with active pCD. Methods Patients with active pCD were retrieved from a prospective multicenter study performed in 41 Dutch (non-)academic hospitals between September 2022 and March 2023. Respondents of the CAF-QoL scale and other health-related QoL questionnaires (sIBDQ and EQ-5D-5L3,4) at baseline were included. After translation of the CAF-QoL scale to Dutch, patient representatives verified the questionnaire’s comprehensibility. Prospective validation comprised the assessment of construct validity, internal consistency, test-retest reliability and responsiveness. Item response theory (IRT) was used to investigate the discriminative power of individual CAF-QoL items and to test for differential item functioning (DIF), examining whether each item behaves equally across all respondents. Results Questionnaires were completed by 264 patients (response rate 64%; female 56%) (Table 1). The median pCD duration at inclusion was 3.0 years (IQR 1.0 – 8.0). Evaluation of construct validity found a moderate correlation between CAF-QoL and sIBDQ (r -0.61, p<0.01) and EQ-5D-5L (r -0.58 [utility] and r -0.42 [VAS], p<0.01) scores. Furthermore, the CAF-QoL scale demonstrated excellent internal consistency (Cronbach’s alpha 0.93), good stability (intraclass correlation coefficient 0.83) and responded well to improvement and worsening of pCD symptoms (p<0.01)(Table 2). Discrimination values revealed that most items (73%) possessed a moderate to high ability to predict poor QoL; items pertaining to the impact of pCD on daily life had the greatest predictive abilities. No clinically relevant DIF was found among patients of different ages, sexes or education levels. Conclusion In this prospective multicenter study, the CAF-QoL scale was validated as a robust tool to measure pCD-specific QoL among Dutch patients with active pCD. Therefore, this scale appears to be well suited for use in clinical practice. Further studies are required to establish a minimal clinically important difference for the CAF-QoL scale; this would determine the smallest change in test scores perceptible to the patient, enabling effective monitoring of treatment outcomes. References 1.Panes J, Reinisch W, Rupniewska E, et al. Burden and outcomes for complex perianal fistulas in crohn's disease: Systematic review. World J Gastroenterol 2018;24:4821-34 2.Adegbola SO, Dibley L, Sahnan K, et al. Development and initial psychometric validation of a patient-reported outcome measure for Crohn's perianal fistula: the Crohn's Anal Fistula Quality of Life (CAF-QoL) scale. Gut. 2021;70(9):1649-1656. 3.Irvine EJ, Zhou Q, Thompson AK. The Short Inflammatory Bowel Disease Questionnaire: a quality of life instrument for community physicians managing inflammatory bowel disease. CCRPT Investigators. Canadian Crohn's Relapse Prevention Trial. Am J Gastroenterol. 1996;91(8):1571-1578. 4.Herdman M, Gudex C, Lloyd A, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20(10):1727-1736.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.004 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".