Quality of Life--measurement in inflammatory bowel disease

Health-related Quality of Life (HRQOL) is gaining increased notoriety in the study of chronic diseases. These indices provide a subjective, quantitative assessment of health perception and function in the physical, social and emotional domains which is distinct from measures of disease activity. HRQOL tools can be promoted to evaluate the natural history of the disease, to catalogue the needs of inflammatory bowel disease (IBD) patients, to focus the direction of research and allocation of limited resources, and to assess outcome in clinical trials. While generic measures of HRQOL permit comparison among disease populations, they may be too imprecise to reflect impairment of function in young IBD patients or to gauge response to therapy. Several IBD specific HRQOL measures have been developed to address these applications. A survey using the McMaster IBDQ showed that 182 IBD patients had significantly worse HRQOL than 48 normal controls. Several studies have observed that patients with ulcerative colitis experience better HRQOL than those with Crohn's disease and Crohn's patients who have had surgery have an even poorer HRQOL. Two clinical trials in Crohn's disease have utilized the IBDQ to measure therapeutic efficacy and demonstrated that HRQOL compared favourably with other measures of outcome. Self-administration of the IBDQ may reduce costs of clinical research without altering results. Future direction of HRQOL in IBD may be targeted at long-range assessment of costs and benefits to therapy.