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A comparison of physician-rated disease severity and patient reported outcomes in mild to moderately active ulcerative colitis
Abstract
BACKGROUND AND AIMS: The aim was to derive health state utility scores in ulcerative colitis (UC) by establishing the relationship between the physician-rated ulcerative colitis disease activity index (UCDAI) and a patient reported EQ-5D by statistically mapping the two instruments. METHODS: In a randomised controlled trial comparing oral plus enema mesalazine treatment with oral mesalazine treatment alone (PINCE), UCDAI and EQ-5D scores were collected in parallel from patients with active UC. From these data, multinomial logistic regression was used to estimate response probabilities to each of the five domains of the EQ-5D index from assessment of UC disease severity using original and abbreviated (no endoscopy) versions of the UCDAI. Predicted EQ-5D responses were converted by Monte Carlo simulation to the EQ-5D index for predicting health-related quality of life (HRQoL). The reliability of the algorithm was tested using UCDAI scores from a second mesalazine RCT (PODIUM). RESULTS: The abbreviated-UCDAI showed comparable explanatory performance to the full UCDAI. For patients in remission, mean utility was 0.939, 0.944, and 0.940U for PINCE(estimated), PINCE(observed), and PODIUM, respectively. Mild/moderate and relapsing cases showed mean utilities of 0.801, 0.811, and 0.775, respectively; whilst for those in severe relapse, the mean utilities were 0.630, 0.700 and 0.660 units, respectively. The mean squared error between actual and predicted utilities from observations in PINCE was 0.019. CONCLUSION: Response mapping of UC activity to EQ-5D domains produced reliable estimates of patient-rated health state utility consistent with UCDAI rated severity. Comparing abbreviated-UCDAI and full UCDAI suggests that inclusion of endoscopy scores has limited predictive value in estimating patient HRQoL.
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Relative to rheumatoid arthritis patients, the endometriosis patients had worse WPAI scores in every domain except absenteeism, where the rates were 13% versus 46%.
“Compared to patients with rheumatoid arthritis, patients in this study reported worse WPAI outcomes in all domains measured except for absenteeism (13% vs. 46%) (47).”
From Quantification of the impact of endometriosis symptoms on health-related quality of life and work productivity (2011) · cites this paper as [47]
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Metadata
- Authors
- Poole, C. D., Connolly, M. P., Nielsen, S. K., Currie, C. J., & Marteau, P.
- Affiliations
- Ferring Pharmaceuticals (Switzerland) (CH)
- Cardiff University (GB)
- Assistance Publique – Hôpitaux de Paris (FR)
- Corresponding author
- Connolly, Mark P.
- Venue
- Journal of Crohn's and Colitis
- Publisher
- Oxford University Press (OUP)
- Published
- 2010-09
- Volume
- 4
- Issue
- 3
- Pages
- 275-282
- ISSN
- 1873-9946 (ISSN-L)
- OpenAlex
- W2015789265
- Cited by
- 23
- References
- 27
- Citations by year
- 2024: 1 · 2022: 2 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 2 · 2013: 3 · 2012: 2
- FWCI
- 2.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Crohn s and Colitis (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- ulcerative colitis, health-related quality of life
- MeSH terms
- Adult, Colitis, Ulcerative, Female, Health Status Indicators, Humans, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Severity of Illness Index, Logistic Models, Quality-Adjusted Life Years
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