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Steiner IM, Bokemeyer B, Stargardt T. Mapping from SIBDQ to EQ-5D-5L for patients with inflammatory bowel disease. Eur J Health Econ 2024; 25:539-548. [PMID: 37368061 PMCID: PMC10972987 DOI: 10.1007/s10198-023-01603-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 05/31/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Clinical studies commonly use disease-specific measures to assess patients' health-related quality of life. However, economic evaluation often requires preference-based utility index scores to calculate cost per quality-adjusted life-year (QALY). When utility index scores are not directly available, mappings are useful. To our knowledge, no mapping exists for the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Our aim was to develop a mapping from SIBDQ to the EQ-5D-5L index score with German weights for inflammatory bowel disease (IBD) patients. METHODS We used 3856 observations of 1055 IBD patients who participated in a randomised controlled trial in Germany on the effect of introducing regular appointments with an IBD nurse specialist in addition to standard care with biologics. We considered five data availability scenarios. For each scenario, we estimated different regression and machine learning models: linear mixed-effects regression, mixed-effects Tobit regression, an adjusted limited dependent variable mixture model and a mixed-effects regression forest. We selected the final models with tenfold cross-validation based on a model subset and validated these with observations in a validation subset. RESULTS For the first four data availability scenarios, we selected mixed-effects Tobit regressions as final models. For the fifth scenario, mixed-effects regression forest performed best. Our findings suggest that the demographic variables age and gender do not improve the mapping, while including SIBDQ subscales, IBD disease type, BMI and smoking status leads to better predictions. CONCLUSION We developed an algorithm mapping SIBDQ values to EQ-5D-5L index scores for different sets of covariates in IBD patients. It is implemented in the following web application: https://www.bwl.uni-hamburg.de/hcm/forschung/mapping.html .
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Affiliation(s)
- Isa Maria Steiner
- Hamburg Center for Health Economics, University of Hamburg, Esplanade 36, 20354, Hamburg, Germany.
| | - Bernd Bokemeyer
- Interdisziplinäres Crohn Colitis Centrum Minden, Märchenweg 17, 32429, Minden, Germany
| | - Tom Stargardt
- Hamburg Center for Health Economics, University of Hamburg, Esplanade 36, 20354, Hamburg, Germany
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Oliveira R, Martins V, de Sousa HT, Roseira J. Food-Related Quality of Life and Its Predictors in Inflammatory Bowel Disease. Dig Dis Sci 2024:10.1007/s10620-024-08333-9. [PMID: 38457117 DOI: 10.1007/s10620-024-08333-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is associated with dietary restrictions and food- and drink-driven daily life limitations. Food-related quality of life (FR-QoL) is still an under-addressed issue in IBD. AIM We aimed to study determinants of FR-QoL in an IBD cohort, namely objective measures of disease activity. METHODS A cross-sectional case-control study was conducted in a Tertiary Hospital, including adult patients with IBD (cases) and blood donors or subjects referred for colorectal polypectomies (controls). Participants answered an anonymous multimodal questionnaire including sociodemographic and clinical data, the validated FR-QoL-29, and the SIBDQ tools. Patients' disease activity was previously assessed by a physician using symptom-based scores and biomarkers (Harvey-Bradshaw index, partial Mayo score, fecal calprotectin). RESULTS A total of 239 patients with IBD and 126 controls were included. Patients with active disease had poorer FR-QoL than patients in remission (80.0 [56.0-99.0] vs. 103.5 [81.0-129.9], p < 0.001). Still, patients with IBD had significantly lower FR-QoL compared with controls (99.0 [76.0-126.0] vs. 126.0 [102.8-143.0], p < 0.001), irrespective of disease activity. FR-QoL correlated with health-related quality of life, measured by SIBDQ (r = 0.490, p < 0.001), and was significantly impaired by patients' depressive humor (84.0 [61.0-112.0] vs. 108.0 [88.0-130.5], p < 0.001). Globally, FR-QoL compromise was mostly related to persistent worries about food, concerns about food-related symptoms, and life disruption due to eating and drinking. CONCLUSIONS Patients with IBD showed significant FR-QoL impairment, irrespective of disease type and activity. Related psychosocial factors, such as the patient's affective status and fear around eating, warrant a need for a multidisciplinary approach to IBD, including tailored nutritional counseling.
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Affiliation(s)
- Raquel Oliveira
- Gastroenterology Department, Algarve University Hospital Centre, Estrada do Poço Seco, 8500-338, Portimão, Portugal.
- Algarve Biomedical Centre (ABC), University of the Algarve, Faro, Portugal.
| | - Viviana Martins
- Gastroenterology Department, Algarve University Hospital Centre, Estrada do Poço Seco, 8500-338, Portimão, Portugal
- Algarve Biomedical Centre (ABC), University of the Algarve, Faro, Portugal
| | - Helena Tavares de Sousa
- Gastroenterology Department, Algarve University Hospital Centre, Estrada do Poço Seco, 8500-338, Portimão, Portugal
- Algarve Biomedical Centre (ABC), University of the Algarve, Faro, Portugal
| | - Joana Roseira
- Gastroenterology Department, Algarve University Hospital Centre, Estrada do Poço Seco, 8500-338, Portimão, Portugal
- Algarve Biomedical Centre (ABC), University of the Algarve, Faro, Portugal
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Sachan A, Thungapathra M, Kaur H, Prasad KK, Jassal RS, Sharma V, Jena A, Singh AK, Vaiphei K, Samanta J, Sharma AK, Bhadada SK, Dutta U. Comprehensive assessment of nutritional and functional status of patients with ulcerative colitis and their impact on quality of life. Indian J Gastroenterol 2024; 43:254-263. [PMID: 38396280 DOI: 10.1007/s12664-024-01539-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Patients with ulcerative colitis (UC) are likely to have poor nutritional intake and increased gut losses. This study was designed to study the prevalence and predictors of nutritional deficiencies in patients with UC and their impact on the quality of life (QOL). METHODS A prospective study was conducted among consenting patients with UC (cases) and healthy relatives of the cases (controls) visiting a university teaching hospital. They were assessed for clinical, demographic, endoscopic (Mayo score) and histological profile (Robart's score). They were assessed for the presence of macronutrient and micronutrient deficiency, anthropometry, functional status (muscle strength by dynamometer and sit-to-stand test) and the quality of life (short inflammatory bowel disease questionnaire [SIBDQ]). A SIBDQ score of ≤ 50 was considered poor QOL. RESULTS We studied 126 cases and 57 healthy controls (age [mean ± SD] 37.7 ± 13.2 years vs. 34.40 ± 11.05 years; [p = 0.10] females [38.1% vs. 38.7%]; p = 0.94). Cases more often were underweight (28% vs. 3.5%; p < 0.001), had low mid arm circumference (45% vs. 12%; p < 0.0001), lower functional status in the form of weaker hand grip strength (67% vs. 45.6%; p = 0.007) and weaker lower limb strength (80% vs. 42%; p < 0.0001). Cases more often had the evidence of macronutrient deficiencies: total serum protein deficiency (31% vs. 3.5%; p < 0.0001), serum albumin deficiency (25.4% vs. 0.00%; p < 0.0001) and cholesterol deficiency (63% vs. 28%; p < 0.0001). Micronutrient deficiencies were highly prevalent among cases: calcium (44%), phosphate (21%), magnesium (11%), zinc (76%), iron (87%), folate (16%), vitamin B12 (10%) and vitamin D (81%). Most cases had a poor quality of life (85/126; 67.5%). Factors associated with poor QOL were low hemoglobin, serum albumin, zinc and vitamin D levels and histologically active disease. On multi-variate analysis, low vitamin D levels (odds ratio [OR] = 6.1; 95% confidence interval [CI]: 1.9-19.7) and histologically active disease (OR = 4.0; 95% CI: 1.6-9.9) were identified as independent predictors of poor QOL. CONCLUSIONS Macronutrient deficiency, micronutrient deficiency, lower functional status and poorer QOL are highly prevalent among patients with UC. The independent predictors of poor QOL were histologically active disease and low serum vitamin D levels. Identifying and correcting the deficiencies may help in improving the QOL of patients with UC.
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Affiliation(s)
- Anurag Sachan
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - M Thungapathra
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Harmandeep Kaur
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Kaushal Kishor Prasad
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Ravjeet Singh Jassal
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Vishal Sharma
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Anuraag Jena
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Anupam Kumar Singh
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Kim Vaiphei
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Jayanta Samanta
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Arun Kumar Sharma
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Sanjay Kumar Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Usha Dutta
- Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
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Zhang SJ, Luo JF, Peng B, Hou JT, Xu Q, Chen LX, Li HB, Liu SY, Zhong JM, He ZF, Chen XL. Reliability and validity of the Chinese version of the short inflammatory bowel disease questionnaire. Shijie Huaren Xiaohua Zazhi 2022; 30:17-23. [DOI: 10.11569/wcjd.v30.i1.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The short inflammatory bowel disease questionnaire (SIBDQ) is a widely used assessment tool to measure the health-related quality of life of patients with inflammatory bowel disease (IBD).
AIM To translate and validate the SIBDQ in Chinese IBD patients.
METHODS A simplified Chinese version of SIBDQ (SIBDQ-C) was obtained according to Brislin's translation and back-translation procedure. The patients with IBD were measured in the First Affiliated Hospital of Guangzhou University of Chinese Medicine and the First Affiliated Hospital of Sun Yat-Sen University between June 2020 and June 2021. Cronbach's α, split-half reliability, and intraclass correlation coefficient (ICC) were used to test the reliability of the SIBDQ-C. Confirmatory factor analysis was used to evaluate its structural validity.
RESULTS A total of 113 patients with IBD were enrolled, and 112 were eventually included for analysis. Cronbach's α of the SIBDQ-C was 0.90, and split-half coefficient was 0.86. ICCs of the four dimensions ranged from 0.61 to 0.77. Confirmatory factor analysis showed that root mean square error of approximation, non-normed fit index, comparative fit index, and goodness-of-fit index were 0.08, 0.93, 0.97, and 0.92, respectively. There were significant differences in the SIBDQ-C score and the scores of four dimensions in patients with different fecal characters (P < 0.05).
CONCLUSION The SIBDQ-C has good reliability and validity, which can be used to measure the quality of life of patients with IBD in mainland China.
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Affiliation(s)
- Shi-Jing Zhang
- School of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Jian-Feng Luo
- School of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Bin Peng
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510400, Guangdong Province, China
| | - Jiang-Tao Hou
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510400, Guangdong Province, China
| | - Qian Xu
- School of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Li-Xia Chen
- School of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Hui-Biao Li
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou 510400, Guangdong Province, China
| | - Shi-Ying Liu
- School of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Jia-Min Zhong
- School of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Zhen-Fang He
- School of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
| | - Xin-Lin Chen
- School of Basic Medical Science, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China
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Sun D, Chi L, Liu J, Liang J, Guo S, Li S. Psychometric validation of the Chinese version of the Short Inflammatory Bowel Disease Questionnaire and evaluation of its measurement invariance across sex. Health Qual Life Outcomes 2021; 19:253. [PMID: 34743727 PMCID: PMC8572570 DOI: 10.1186/s12955-021-01890-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/31/2021] [Indexed: 12/07/2022] Open
Abstract
Background This study aimed to evaluate the psychometric properties of the Chinese version of the Short Inflammatory Bowel Disease Questionnaire (C-SIBDQ), and its measurement invariance across sex in Chinese patients with inflammatory bowel disease (IBD). Methods Between September 2018 and July 2021, 284 patients with IBD were recruited from a spleen and stomach clinic. All participants completed the C-SIBDQ, 12-item Short-Form Health Survey (SF-12), nine-item Patient Health Questionnaire Depression Scale (PHQ-9), and the seven-item Generalized Anxiety Disorder Scale (GAD-7). Floor and ceiling effects were evaluated by testing frequencies and composition ratios for the minimum and maximum C-SIBDQ scores. Exploratory and confirmatory factor analysis (CFA) were used to evaluate the C-SIBDQ’s factor structure and construct validity. Convergent validity was evaluated through examining bivariate correlations between the C-SIBDQ and the SF-12, PHQ-9, and GAD-7. Internal consistency reliability and retest reliability were evaluated by respectively calculating the Cronbach’s α and the intraclass correlation coefficient (ICC) among a subsample (n = 79) after 2 weeks. The measurement invariance across sex was evaluated through multiple-group CFA. Results The C-SIBDQ scores showed no floor or ceiling effects and had a single-factor structure and good convergent validity, with significant correlations with the SF-12, PHQ-9 and GAD-7. Good internal consistency (Cronbach’s α = 0.920) and test–retest reliability (ICC = 959) were observed. The C-SIBDQ also showed measurement invariance across sex, and females showed higher C-SIBDQ scores than males. Conclusions The C-SIBDQ has high reliability, validity, and stability across sex, and can be used in clinics to assess the health-related quality of life of patients with IBD.
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Affiliation(s)
- Dajuan Sun
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, 250355, China.,Department of Spleen and Stomach Diseases, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014, China
| | - Lili Chi
- Department of Spleen and Stomach Diseases, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014, China.
| | - Jiahui Liu
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Junwei Liang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Song Guo
- Department of Spleen and Stomach Diseases, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250014, China
| | - Shaojie Li
- Department of Social Medicine and Health Service Management, Xiangya School of Public Health, Central South University, Changsha, 410078, China
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