QUALITY-OF-LIFE IN INFLAMMATORY BOWEL-DISEASE - BIASES AND OTHER FACTORS AFFECTING SCORES

Health-Related Quality of Life (HRQOL) measurement has become a key el ement in the assessment of chronic diseases during the execution of cl inical research and in the delivery of hearth care. Poor HRQOL is clea rly recognized in patients with inflammatory bowel disease (IBD) and r elates to the type of disease (Crohn's disease or ulcerative colitis) and disease severity. It is also linked to non-disease elements e.g., gender, age, personality, cultural factors and coping skills. The dyna mic properties of HRQOL may be depicted using different measurement to ols and the portrayal may well differ when using a generic- or a disea se-specific instrument. HRQOL status also changes with time, as do dis ease and non-disease parameters. Several examples of population select ion bias are demonstrated using the Sickness Impact Profile (SIP), the time trade-off and the McMaster Inflammatory Rowel Disease Questionna ire (IBDQ). While HRQOL is generally good in IBD patients, mean HRQOL scores are still significantly depressed compared to normal controls. The IBDQ, a disease-specific HRQOL instrument, has yielded consistent results in both cross-sectional studies and prospective clinical trial s. Such HRQOL instruments can be used to identify the types of new the rapies that are needed, subgroups of patients which might benefit from specific treatments, patient satisfaction, treatment efficacy and eff iciency. These applications must always be undertaken with careful att ention to rigorous research methodology.