Lo B, et al. - This meta-analysis was performed to evaluate the severity of disability and associated factors using the Inflammatory Bowel Disease Disability Index (IBD-DI) and examine the validity of the IBD-DI as a tool. In this systematic review, the researchers found a significant relationship between disease activity, treatment received and disability, although significant heterogeneity was found. As per findings, the IBD-DI was reliable and valid. However, to measure its interpretability, further studies were required.

• The researchers performed a systematic review of cross-sectional studies.
• Patients who had Crohn's disease (CD) and ulcerative colitis (UC) were included and classified as active, in remission, or needing surgery, biological and/or steroid treatment.
• Using the IBD-DI, they included studies assessing disability.
• The studies were captured by electronic and manual searches (January 2017).
• They evaluated the possibility of bias with the Newcastle-Ottawa Scale.

• The researchers included 9 studies with 3167 patients.
• Patients with active disease had higher disability rates than those in remission (SMD [CI95] = 1.49[1.11, 1.88], I² = 94%, P<.01).
• In comparison, patients on biological treatment had lower disability rates than those receiving corticosteroid treatment (SMD [CI95] = -0.22[-0.36, -0.08], I² = 0%, P<.01).
• In this study, disease activity and unemployment were found to be associated factors.
• For internal consistency, the IBD-DI scored “good”, for intra-rater reliability “fair” to “excellent” and for inter-rater reliability “excellent”.
• Construct validity was “moderately strong” to “very strong” and structural validity was seen to be mainly unidimensional.
• While its interpretability was only useful on a group level, the IBD-DI had excellent responsiveness.