The network: a strategy to describe the relationship between quality of life and disease activity. The case of inflammatory bowel disease

Objective Health is a complex and multi-dimensional entity and is neither e asily determined nor easily conveyed to others, Publications have often com bined various variables of disease activity and health-related quality of l ife (HRQoL), used the variables interchangeably or utilized summation indic es to compare health assessment, The aim of this study is to investigate th e relationship between measurements of disease activity and HRQoL, Study design Cross-sectional evaluation of disease activity and HRQoL. Study popolation Two hundred and eleven consecutive patients with ulcerativ e colitis, Setting The catchment area of Linkoping University Hospital, Measurements HRQoL was measured using two questionnaires, the Sickness Impa ct Profile (SIP) and the Rating Form of IBD Patient Concerns (RFIPC), Patie nts were also asked if they were 'feeling fit and well', as a measurement o f general health perception, Disease activity was measured by means of symp tom cards, laboratory tests and sigmoidoscopy. Results The correlations (Spearman's r(r(s))) between variables of disease activity and HRQoL were low. 'Feeling fit and well' was best correlated to worries and concerns (the RFIPC, r(s) 0,32, P < 0,05), while there was a de creasing association with subjective functional status (the SIP, r(s) 0.31, P < 0.05), symptoms (stools per day, r(s) 0.15, not significant) and biolo gical variables (endoscopy score, r(s) 0.04, not significant), Conclusion The correlations between traditional measurements of disease act ivity and various measures of HRQoL are low, We therefore propose a system whereby the process is conceptualized using a 'network strategy', ordering the measurements of disease activity and HRQoL into five dimensions: biolog ical variables, symptoms, functional status, worries and concerns, and heal th perceptions, We feel that this method of interpretation more accurately reflects the overall health of a group of patients with IBD than more tradi tional summation indices. Eur J Gastroenterol Hepatol 11 :1099-1104 (C) 199 9 Lippincott Williams & Wilkins.