P141 - DEVELOPMENT OF A SELF-SCREENING TOOL FOR PERIANAL DISEASE IN PATIENTS WITH CROHN’S DISEASE: A PILOT STUDY
(Room Poster Hall)
19 Jan 18
5:30 PM
-
7:00 PM
Tracks:
Defining Optimal Treatment Algorithms
Backgrounds: Perianal disease including perianal fistula and perianal abscess is known as one of the poor prognostic factors of Crohn’s disease (CD). However, there has been no tool for CD patients to check their perianal symptoms. We aimed to develop self-screening tool for perianal disease in CD patients. Methods: A prospective pilot study was conducted at 3 tertiary referral centers between Jan 2017 and May 2017. Questions regarding perianal symptoms were created by experts using the Delphi method. Each question had a 4-point likert scale. Patients who were diagnosed of CD and followed up for at least 3 months were asked to fill out a self-completed questionnaire. All patients underwent pelvic MRI which was regarded as a gold standard. Results: A total of 49 patients were enrolled in the study (male 73.7%, median age 25 [18-64]), of which 28 showed perianal disease in pelvic MRI. Questionnaires included 5 questions regarding anal discharge, anal pain, anal bleeding, perianal heat sense and incomplete sense of defecation, respectively. Total score showed a significant correlation with perianal disease (Spearman correlation ρ=0.439, p=0.002) whereas C reactive protein, WBC and Crohn's disease activity index score did not. Receiver operating characteristic (ROC) analysis showed the highest area under the curve (AUC) when variables of anal discharge and anal pain were used (AUC=0.804, 95% confidence interval 0.656-0.952, p=0.002). When a cut-off value was set as score 1, sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the diagnosis of perianal disease were 0.917, 0.667, 0.815, 0.833 and 0.842, respectively. Conclusions: This pilot study shows that simple questions, as to anal discharge and anal pain in particular, might be a useful self-screening tool of the diagnosis of perianal disease for CD patients. Further study is needed to confirm the efficacy of this questionnaire.