47 Optimal Disease Control in Crohn’s Disease and Ulcerative Colitis is Associated With Better Quality of Life
Notice bibliographique
Résumé
Background: Optimal disease control (ODC) in inflammatory bowel disease (IBD) has previously been defined in Views on IBD Expectations and Well-being - Patients and Treatment providers (VIEW-PT): an analysis based on the IBD Disease Specific Programme (DSP)™. In this study, we assessed a composite outcome termed ODC-11, representing 11 of the 13 features included in the definition of ODC, among patients with Crohn’s disease (CD) and ulcerative colitis (UC), and determined the association between ODC-11 and health-related quality of life (HRQoL). Methods: Data were analyzed from the Adelphi IBD DSP, a cross-sectional survey with retrospective data collection of physicians and their patients with IBD, in the United States, France, Germany, Italy, Spain, and the United Kingdom (2020–21 and 2023–24). Features of disease control were determined by physician assessment and patient self-report, with the achievement of ODC-11 requiring the absence of lower gastrointestinal bleeding, bowel urgency (including night-time urgency), fecal incontinence, abdominal pain, fatigue, sleep disturbance due to CD/UC, extraintestinal manifestations, steroid use and impaired HRQoL (EQ visual analogue scale (VAS) ≥80). Additional requirements were normalized bowel movement frequency and complete mucosal healing. Biomarkers and restored mental health were features of ODC that were not included since these were not consistently recorded. Included were adults (≥18 years) with moderate-to-severe UC or CD without IBD-related bowel resection and receiving care from eligible HCPs, specifically gastroenterologists, except in France, where internal medicine specialists were also eligible (2023–24). The association of ODC-11 and HRQoL was assessed by bivariate analyses. Measures included the Work Productivity and Activity Impairment Questionnaire (WPAI), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and EQ-5D-5L dimensions, and used observed data, excluding patients with missing values for the variables in each specific analysis. Results: Of 2,513 patients with UC or CD, 10.4% (n = 262) achieved OCD-11. Incomplete disease control (89.6%, n = 2251) was reflective of abdominal pain (52.9%), reduced HRQoL (EQ VAS <80) (46.2%), disturbed sleep or insomnia (44.2%), fatigue (42.7%), incomplete mucosal healing (41.5%), bowel urgency (37.7%), abnormal bowel movement frequency (28.3%), corticosteroid use (22.1%), uncontrolled extraintestinal manifestations (21.0%), bleeding (18.9%), and fecal incontinence (4.6%). When comparing WPAI elements, those who achieved ODC-11 experienced, on average, 21.3% less work productivity loss and 22.8% less impairment in daily activities than those with incomplete disease control (P < 0.0001). Patients who achieved ODC-11 scored, on average, 1.5 points higher in systemic, social, and emotional SIBDQ sub-scores (1–7; higher = better QoL), and 1.6 points higher in bowel-related quality of life. The mean SIBDQ total score (10–70) increased by 15.1 points in this group compared to those with incomplete disease control (all P < 0.0001). In EQ-5D-5L dimensions, patients who achieved ODC-11 reported 14.1% fewer mobility problems, 9.5% fewer self-care problems, 34% fewer difficulties with usual activities, 54.2% fewer experiences of pain, and 40.2% fewer experiences with anxiety (all P < 0.0001) and a higher mean EQ-5D utility score (+0.144). Conclusions: Patients achieving disease control (ODC-11) were more likely to exhibit significant improvements in HRQoL across multiple domains. These findings highlight the potential value of pursuing comprehensive disease management strategies to enhance overall patient outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».