Clinical Rheumatology

, Volume 37, Issue 4, pp 1037–1044 | Cite as

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

  • Marco Di Carlo
  • Michele Maria Luchetti
  • Devis Benfaremo
  • Eleonora Di Donato
  • Piergiorgio Mosca
  • Stefania Maltoni
  • Antonio Benedetti
  • Armando Gabrielli
  • Walter Grassi
  • Fausto Salaffi
Original Article
  • 181 Downloads

Abstract

To develop and to test in a preliminary way a new self-administered screening tool, called DETection of Arthritis in Inflammatory boweL diseases (DETAIL) questionnaire, in patients suffering from inflammatory bowel disease (IBD) not previously diagnosed as having a spondyloarthritis (SpA). DETAIL questionnaire was realized through the interrogation of 95 experts. They were asked to rate the importance of a list of items, derived from a review of the referral models of SpA, to detect the SpA manifestations in IBD patients. The six top-rated items composed the questionnaire, tested in IBD patients not already diagnosed having a SpA. One-hundred and twenty-eight patients were tested with the DETAIL questionnaire in the gastroenterology setting. After the rheumatologic assessment, in 21 (16.4%) subjects was diagnosed a SpA according to the Assessment of SpondyloArthritis international Society (ASAS) classification criteria. Of the six items of the DETAIL questionnaire, the best positive likelihood ratio (LR+) was found in item 2 (LR+ 3.82), exploring dactylitis, and in item 6 (LR+ 3.82) and item 5 (LR+ 3.40), two questions exploring inflammatory low back pain. Enthesitis (item 3—LR+ 2.87) and peripheral synovitis (item 1 – LR+ 2.81) gave similar results, while item 4, exploring the duration of low back pain, resulted in the worst performance (LR+ 1.99). Three of the six items answered in affirmative way gave a post-test probability ≥ 75%. The presence of a fibromyalgia represents a major confounder. The DETAIL questionnaire showed good screening properties that need to be confirmed in broader cohorts.

Keywords

Crohn’s disease Referral Screening tools Spondyloarthritis Ulcerative colitis 

Notes

Acknowledgements

We are grateful to all the italian colleagues who participated to this study: Bendia E, Ancona; Bolognini L, Ancona; Bruzzese V, Roma; Chimenti MS, Roma; Clementi C, Roma; Conigliaro P, Roma; Di Sario A, Ancona; Faggioli P, Legnano; Fava G, Ancona; Hassan C, Roma; Laganà B, Roma; Lorenzetti R, Roma; Martin Martin LS, Albano Laziale; Paroli M, Latina; Pica R, Roma; Picchianti Diamanti A, Roma; Pugliese D, Roma; Ribaldone DG, Torino; Rinaldi T, Latina; Santo L, Barletta; Santoboni G, Viterbo; Scolieri P, Roma; Scarpato S, Salerno; Scribano ML, Roma; Serra F, Roma; and Zullo A, Roma.

Compliance with ethical standard

Disclosures

None.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2017

Authors and Affiliations

  • Marco Di Carlo
    • 1
  • Michele Maria Luchetti
    • 2
  • Devis Benfaremo
    • 2
  • Eleonora Di Donato
    • 1
  • Piergiorgio Mosca
    • 3
  • Stefania Maltoni
    • 4
  • Antonio Benedetti
    • 5
  • Armando Gabrielli
    • 2
  • Walter Grassi
    • 1
  • Fausto Salaffi
    • 1
  1. 1.Rheumatological ClinicUniversità Politecnica delle Marche, “Carlo Urbani” HospitalAnconaItaly
  2. 2.Medical ClinicUniversità Politecnica delle MarcheAnconaItaly
  3. 3.Digestive System Diseases, Endoscopy and Inflammatory Bowel Diseases UnitOspedali RiunitiAnconaItaly
  4. 4.Gastroenterology Unit“Principe di Piemonte” HospitalAnconaItaly
  5. 5.Clinic of Gastroenterology and HepatologyUniversità Politecnica delle MarcheAnconaItaly

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