Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 21:16:17562848231202159.
doi: 10.1177/17562848231202159. eCollection 2023.

Validity of the self-administered comorbidity questionnaire in patients with inflammatory bowel disease

Reinier Cornelis Anthonius van Linschoten  1   2 , Anouk Sjoukje Huberts  3 , Nikki van Leeuwen  4 , Jan Antonius Hazelzet  4 , Janneke van der Woude  2 , Rachel Louise West  5 , Desirée van Noord  5
Affiliations

Validity of the self-administered comorbidity questionnaire in patients with inflammatory bowel disease

Reinier Cornelis Anthonius van Linschoten et al. Therap Adv Gastroenterol. .

Abstract

Background: The International Consortium for Health Outcomes Measurement has selected the self-administered comorbidity questionnaire (SCQ) to adjust case-mix when comparing outcomes of inflammatory bowel disease (IBD) treatment between healthcare providers. However, the SCQ has not been validated for use in IBD patients.

Objectives: We assessed the validity of the SCQ for measuring comorbidities in IBD patients.

Design: Cohort study.

Methods: We assessed the criterion validity of the SCQ for IBD patients by comparing patient-reported and clinician-reported comorbidities (as noted in the electronic health record) of the 13 diseases of the SCQ using Cohen's kappa. Construct validity was assessed using the Spearman correlation coefficient between the SCQ and the Charlson Comorbidity Index (CCI), clinician-reported SCQ, quality of life, IBD-related healthcare and productivity costs, prevalence of disability, and IBD disease activity. We assessed responsiveness by correlating changes in the SCQ with changes in healthcare costs, productivity costs, quality of life, and disease activity after 15 months.

Results: We included 613 patients. At least fair agreement (κ > 0.20) was found for most comorbidities, but the agreement was slight (κ < 0.20) for stomach disease [κ = 0.19, 95% CI (-0.03; 0.41)], blood disease [κ = 0.02, 95% CI (-0.06; 0.11)], and back pain [κ = 0.18, 95% CI (0.11; 0.25)]. Correlations were found between the SCQ and the clinician-reported SCQ [ρ = 0.60, 95% CI (0.55; 0.66)], CCI [ρ = 0.39, 95% CI (0.31; 0.45)], the prevalence of disability [ρ = 0.23, 95% CI (0.15; 0.32)], and quality of life [ρ = -0.30, 95% CI (-0.37; -0.22)], but not between the SCQ and healthcare or productivity costs or disease activity (|ρ| ⩽ 0.2). A change in the SCQ after 15 months was not correlated with a change in any of the outcomes.

Conclusion: The SCQ is a valid tool for measuring comorbidity in IBD patients, but face and content validity should be improved before being used to correct case-mix differences.

Keywords: comorbidities; inflammatory bowel disease; value-based healthcare.

PubMed Disclaimer

Conflict of interest statement

RCAvL has nothing to disclose. ASH has nothing to disclose. NvL has nothing to disclose. JAH has nothing to disclose. CJvdW has received research grants from ZonMW, Falk, and Pfizer; has received consulting fees from Janssen, Galapagos, and Pfizer; and has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Ferring and AbbVie, all outside the submitted work. RLW reports personal fees from Ferring, Pfizer, Galapagos, AbbVie, and Janssen outside the submitted work. DvN reports personal fees from Janssen, Takeda, AbbVie, and Galapagos outside the submitted work.

References

    1. Lönnfors S, Vermeire S, Greco M, et al. IBD and health-related quality of life – discovering the true impact. J Crohns Colitis 2014; 8: 1281–1286. - PubMed
    1. Knowles SR, Keefer L, Wilding H, et al. Quality of life in inflammatory bowel disease: a systematic review and meta-analyses-part II. Inflamm Bowel Dis 2018; 24: 966–976. - PubMed
    1. Zhao M, Gönczi L, Lakatos PL, et al. The burden of inflammatory bowel disease in Europe in 2020. J Crohns Colitis 2021; 15: 1573–1587. - PubMed
    1. World Health Organization. Global health expenditure database, http://apps.who.int/nha/database/Select/Indicators/en (2019, accessed 24 December 2019).
    1. Hussey PS, Wertheimer S, Mehrotra A. The association between health care quality and cost: a systematic review. Ann Intern Med 2013; 158: 27–34. - PMC - PubMed

LinkOut - more resources