ACTIVITY SCORES AND QUALITY-OF-LIFE INDEXES IN INFLAMMATORY BOWEL-DISEASE

The clinical course of inflammatory bowel disease and the impact of th erapies on the disease process have traditionally been assessed using composite activity indices. These indices are variably composed of sub jective symptoms, endoscopic appearance, histology of mucosal biopsy s pecimens, and blood, urine, or tissue levels of acute-phase reactants or soluble mediators of inflammation. More recently, health-related qu ality of life (HRQOL, also called functional status), a subjective mea surement of physical, emotional, and social function and perception ha s become a key element in the assessment of health status in inflammat ory bowel disease. Both disease activity and functional status may cha nge with time and specific treatment depending on disease-related feat ures. HRQOL, however, is also affected by disease-independent features . Each index assessing disease activity or HRQOL should be tailored to the study population (eg Crohn's disease, ulcerative colitis, pouchit is, pediatric patients) and research questions of the study. To adequa tely gauge disease severity and health status, both cross-sectional an d prospective studies are critical.