title: Gastrointestinal Symptoms Predictors of Health-Related Quality of Life in Patients With Inflammatory Bowel Disease.
abstract: The aim of the study was to investigate the multidimensional gastrointestinal symptoms predictors of generic health-related quality of life (HRQOL) in pediatric patients with inflammatory bowel disease from the perspectives of pediatric patients and parents.
  
  
  
  The Pediatric Quality of Life Inventory Gastrointestinal Symptoms Scales and Pediatric Quality of Life Inventory 4.0 Generic Core Scales were completed in a 9-site study by 260 families of patients with inflammatory bowel disease. Gastrointestinal Symptoms Scales measuring stomach pain, food and drink limits, gas and bloating, constipation, blood in stool, and diarrhea were identified as clinically important symptom differentiators from healthy controls based on prior findings, and subsequently tested for bivariate and multivariate linear associations with overall HRQOL (Generic Core Scales).
  
  
  
  Stomach pain, food and drink limits, gas and bloating, constipation, blood in stool, and diarrhea were significantly associated with decreased HRQOL in bivariate analyses (P < 0.001). In predictive models utilizing hierarchical multiple regression analyses controlling for age, sex, and race/ethnicity, gastrointestinal symptoms accounted for an additional 40% of the variance in patient self-reported HRQOL (P < 0.001) and 37% of the variance in parent proxy-reported HRQOL (P < 0.001), reflecting large effect sizes. Stomach pain, food and drink limits, and constipation were significant individual patient-reported predictors after controlling for the other gastrointestinal symptoms in the predictive models.
  
  
  
  Patient-reported gastrointestinal symptoms differentially predicted HRQOL. Identifying the specific gastrointestinal symptoms from a standardized multidimensional gastrointestinal symptoms profile that are the most important predictors from the patient perspective facilitates a patient-centered approach for interventions designed to ameliorate impaired HRQOL.
authors.affiliation: *Department of Pediatrics, College of Medicine †Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station ‡Department of Pediatrics, Baylor College of Medicine, Children's Nutrition Research Center §Department of Psychiatry and Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX ||Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH ¶Division of Pediatric Gastroenterology, Children's Medical Center of Dallas, University of Texas Southwestern Medical School, Dallas, TX #Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Harvard Medical School, Boston, MA **Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital Colorado, Aurora, CO ††Division of Gastroenterology, Hepatology and Nutrition, Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL ‡‡Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH §§Department of Psychology, Texas A&M University, College Station, TX ||||Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil ¶¶Department of Pediatric Gastroenterology, Primary Children's Hospital, University of Utah, Salt Lake City, UT.
authors.forename: James W
authors.initials: JW
authors.lastname: Varni
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Shulman
authors.forename: Mariella M
authors.initials: MM
authors.lastname: Self
authors.forename: Shehzad A
authors.initials: SA
authors.lastname: Saeed
authors.forename: Ashish S
authors.initials: AS
authors.lastname: Patel
authors.forename: Samuel
authors.initials: S
authors.lastname: Nurko
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Neigut
authors.forename: Miguel
authors.initials: M
authors.lastname: Saps
authors.forename: James P
authors.initials: JP
authors.lastname: Franciosi
authors.forename: Jolanda M
authors.initials: JM
authors.lastname: Denham
authors.forename: George M
authors.initials: GM
authors.lastname: Zacur
authors.forename: Chelsea V
authors.initials: CV
authors.lastname: Dark
authors.forename: Cristiane B
authors.initials: CB
authors.lastname: Bendo
authors.forename: John F
authors.initials: JF
authors.lastname: Pohl
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000150:complications* / Q000503:physiopathology; D003248:Constipation / Q000209:etiology*; D003424:Crohn Disease / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D011788:Quality of Life; D012044:Regression Analysis; D057566:Self Report; D012720:Severity of Illness Index; D063189:Symptom Assessment