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Research ArticleSpondyloarthritis

Multicenter Validation of the DETAIL Questionnaire for the Screening of Spondyloarthritis in Patients With Inflammatory Bowel Diseases

Devis Benfaremo, Michele Maria Luchetti, Marco Di Carlo, Bruno Laganà, Andrea Picchianti-Diamanti, Francesco Carubbi, Roberta Pica, Maria Sole Chimenti, Roberto Lorenzetti, Palma Scolieri, Vincenzo Bruzzese, Antonio Benedetti, Roberta Ramonda, Roberto Giacomelli, Fausto Salaffi, Armando Gabrielli and on behalf of the GRADES-IBD Study Group
The Journal of Rheumatology February 2021, 48 (2) 179-187; DOI: https://doi.org/10.3899/jrheum.200364
Devis Benfaremo
1D. Benfaremo, MD, M.M. Luchetti, MD, M. Di Carlo, MD, F. Salaffi, MD, PhD, A. Gabrielli, MD, A. Benedetti, MD, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona;
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Michele Maria Luchetti
1D. Benfaremo, MD, M.M. Luchetti, MD, M. Di Carlo, MD, F. Salaffi, MD, PhD, A. Gabrielli, MD, A. Benedetti, MD, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona;
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  • For correspondence: m.luchetti@staff.univpm.it
Marco Di Carlo
1D. Benfaremo, MD, M.M. Luchetti, MD, M. Di Carlo, MD, F. Salaffi, MD, PhD, A. Gabrielli, MD, A. Benedetti, MD, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona;
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Bruno Laganà
2B. Laganà, MD, A. Picchianti-Diamanti, MD, PhD, Department of Clinical and Molecular Medicine, S. Andrea University Hospital, “Sapienza” University, Rome;
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Andrea Picchianti-Diamanti
2B. Laganà, MD, A. Picchianti-Diamanti, MD, PhD, Department of Clinical and Molecular Medicine, S. Andrea University Hospital, “Sapienza” University, Rome;
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Francesco Carubbi
3F. Carubbi, MD, PhD, R. Giacomelli, MD, PhD, Rheumatology Unit, University Hospital “S. Salvatore”, Department of Clinical and Biotechnologic Sciences, University of L’Aquila;
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Roberta Pica
4R. Pica, MD, UOS Gastroenterologia Territoriale, ASL Roma 2, Rome;
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Maria Sole Chimenti
5M.S. Chimenti, MD, UOC Reumatologia, Dipartimento di Medicina dei Sistemi, Università di Tor Vergata, Roma;
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Roberto Lorenzetti
6R. Lorenzetti, MD, UOC Gastroenterologia, Polo Ospedaliero Nuovo Regina Margherita - S.Spirito, Rome;
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Palma Scolieri
7P. Scolieri, MD, V. Bruzzese, MD, UOC Medicina Interna e Reumatologia, Polo Ospedaliero Nuovo Regina Margherita - S.Spirito, Rome;
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Vincenzo Bruzzese
7P. Scolieri, MD, V. Bruzzese, MD, UOC Medicina Interna e Reumatologia, Polo Ospedaliero Nuovo Regina Margherita - S.Spirito, Rome;
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Antonio Benedetti
1D. Benfaremo, MD, M.M. Luchetti, MD, M. Di Carlo, MD, F. Salaffi, MD, PhD, A. Gabrielli, MD, A. Benedetti, MD, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona;
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Roberta Ramonda
8R. Ramonda, MD, PhD, UOC di Reumatologia, Dipartimento di Medicina DIMED, Università di Padova, Italy.
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Roberto Giacomelli
3F. Carubbi, MD, PhD, R. Giacomelli, MD, PhD, Rheumatology Unit, University Hospital “S. Salvatore”, Department of Clinical and Biotechnologic Sciences, University of L’Aquila;
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Fausto Salaffi
1D. Benfaremo, MD, M.M. Luchetti, MD, M. Di Carlo, MD, F. Salaffi, MD, PhD, A. Gabrielli, MD, A. Benedetti, MD, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona;
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Armando Gabrielli
1D. Benfaremo, MD, M.M. Luchetti, MD, M. Di Carlo, MD, F. Salaffi, MD, PhD, A. Gabrielli, MD, A. Benedetti, MD, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona;
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Abstract

Objective. Spondyloarthritis (SpA) is among the most frequent extraintestinal manifestations of inflammatory bowel diseases (IBD). In this study, we aimed to validate the DETection of Arthritis in Inflammatory boweL diseases (DETAIL) questionnaire in a multicenter cohort of patients with IBD enrolled at 11 gastroenterology units.

Methods. From October 2018 to March 2019, consecutive adult patients with IBD, either Crohn disease or ulcerative colitis, independently filled out the DETAIL questionnaire in the outpatient waiting room. Within 2 weeks a blinded rheumatologist assessed all the patients, irrespective of the DETAIL results, and classified them to be affected or not by SpA. The performance of the questions was evaluated through Bayesian analysis.

Results. Overall, 418 patients with IBD filled out the DETAIL questionnaire. Upon rheumatological evaluation, 102 (24.4%) patients received a diagnosis of SpA. Of the 6 questions, the best performances were found in question 6 [positive likelihood ratio (LR)+ 3.77], reporting inflammatory back pain at night, and in question 3 (LR+ 3.31), exploring Achilles enthesitis. The presence of back pain lasting > 3 months (LR+ 2.91), back pain with inflammatory features (LR+ 2.55), and a history of dactylitis (LR+ 2.55), also showed a fairly good performance, whereas a history of peripheral synovitis was slightly worse (LR+ 2.16). The combination of at least 3 questions answered affirmatively yielded a posttest probability of SpA of 80% or more. The presence of alternative diagnoses, such as osteoarthritis or fibromyalgia, represented a minor confounder.

Conclusion. The DETAIL questionnaire is a useful tool for the early detection of SpA in IBD.

Key Indexing Terms:
  • Crohn disease
  • inflammatory bowel diseases
  • spondyloarthritis
  • ulcerative colitis
  • Accepted for publication July 3, 2020.
  • Copyright © 2021 by the Journal of Rheumatology
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1 Feb 2021
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Multicenter Validation of the DETAIL Questionnaire for the Screening of Spondyloarthritis in Patients With Inflammatory Bowel Diseases
Devis Benfaremo, Michele Maria Luchetti, Marco Di Carlo, Bruno Laganà, Andrea Picchianti-Diamanti, Francesco Carubbi, Roberta Pica, Maria Sole Chimenti, Roberto Lorenzetti, Palma Scolieri, Vincenzo Bruzzese, Antonio Benedetti, Roberta Ramonda, Roberto Giacomelli, Fausto Salaffi, Armando Gabrielli, on behalf of the GRADES-IBD Study Group
The Journal of Rheumatology Feb 2021, 48 (2) 179-187; DOI: 10.3899/jrheum.200364

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Multicenter Validation of the DETAIL Questionnaire for the Screening of Spondyloarthritis in Patients With Inflammatory Bowel Diseases
Devis Benfaremo, Michele Maria Luchetti, Marco Di Carlo, Bruno Laganà, Andrea Picchianti-Diamanti, Francesco Carubbi, Roberta Pica, Maria Sole Chimenti, Roberto Lorenzetti, Palma Scolieri, Vincenzo Bruzzese, Antonio Benedetti, Roberta Ramonda, Roberto Giacomelli, Fausto Salaffi, Armando Gabrielli, on behalf of the GRADES-IBD Study Group
The Journal of Rheumatology Feb 2021, 48 (2) 179-187; DOI: 10.3899/jrheum.200364
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Keywords

CROHN DISEASE
INFLAMMATORY BOWEL DISEASES
SPONDYLOARTHRITIS
ULCERATIVE COLITIS

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Keywords

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