Self-administered screening questionnaires for spondyloarthritis in inflammatory bowel disease: A systematic review

Although musculoskeletal symptoms are common in patients with inflammatory bowel disease (IBD), spondyloarthritis (SpA) remains underdiagnosed. This systematic review aimed at identifying and comparing self-administered screening questionnaires for SpA in IBD patients.

We conducted a systematic review according to PRISMA guidelines using PubMed, Cochrane, and ACR/EULAR congress databases, with the last search on April 21, 2024. Studies focusing on self-administered screening questionnaires for SpA in IBD patients were included. We extracted questionnaire characteristics and their psychometric data. The content validity of each questionnaire was assessed using the COSMIN method.

A total of 1491 articles were screened. Eight were included and six screening questionnaires were identified. Two questionnaires assessed axial, one peripheral and three both axial and peripheral symptoms of SpA. The IBIS-Q questionnaire showed the highest sensitivity (92.7 %), while the Queiro's axial questionnaire had the highest specificity (89.8 %). The DETAIL questionnaire gave the highest post-test probability to have a SpA with a positive likelihood ratio of at least 14, using a threshold of three affirmative responses. None of these questionnaires met all criteria of the COSMIN methodology to evaluate their quality. The content validity of the questionnaires was judged to be sufficient or inconsistent by reviewers with moderate qualities of evidence at best.

Six self-administered questionnaires have been developed to screen for SpA in IBD patients. Limited methodological transparency hinders direct comparison. Although none of the available questionnaires fully meets validation standards, the DETAIL questionnaire appears to offer the greatest clinical potential, despite only moderate-quality evidence.