47 Optimal Disease Control in Crohn’s Disease and Ulcerative Colitis is Associated With Better Quality of Life
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".