title: Patient-Reported Outcomes of Quality of Life, Functioning, and GI/Psychiatric Symptom Severity in Patients with Inflammatory Bowel Disease (IBD).
abstract: Patients with inflammatory bowel disease (IBD) are at risk for psychiatric disorders that impact symptom experience and health-related quality of life (HRQOL). Therefore, comprehensive biopsychosocial assessments should be considered in ambulatory care settings. Patient-Reported Outcomes Measurement Information System (PROMIS) measures created by the National Institutes of Health have shown construct validity in a large IBD internet-based cohort, but their validity in ambulatory settings has not been examined. We sought to validate PROMIS patient-reported measures of HRQOL, functioning, and psychiatric symptom severity at a tertiary IBD clinic.
  
  
  
  Adult patients (n = 110) completed the PROMIS Global Health scale, PROMIS-29, SF-12, and WHODAS 2.0. Pearson's correlation coefficients (r) determined the relationships between scores to validate the PROMIS Global Health Physical and Mental metrics, compared with the SF-12 and WHODAS 2.0. We compared these measures by disease subtype of Crohn's disease or ulcerative colitis.
  
  
  
  PROMIS measures were highly correlated (r range = 0.64-0.82) with standard measures of HRQOL and functioning. On the PROMIS Global Health measures, 20.9% had impaired physical health, and 13.7% had impaired mental health. Impairments were reported in pain interference (20% of patients), anxiety (18.2%), satisfaction with social role (15.5%), physical functioning (10.9%), fatigue (10%), depression (7.3%), and sleep disturbance (5.5%). Patients with Crohn's disease had worse scores than those with ulcerative colitis on measures of the global physical health (P = 0.027), physical functioning (P = 0.047), and pain interference (P = 0.0009).
  
  
  
  PROMIS instruments provide valid assessment of HRQOL and functioning in ambulatory adults with IBD. Of note, patients with Crohn's disease demonstrated significantly worse impairments than those with ulcerative colitis.
authors.affiliation: *Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California;†Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California;‡Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California;§Department of Psychology, California School of Professional Psychology, Alliant International University, Los Angeles, California; and‖Biostatistics Core, Research Institute and Clinical and Translational Science Institute (CTSI), Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Waguih W
authors.initials: WW
authors.lastname: IsHak
authors.forename: Dana
authors.initials: D
authors.lastname: Pan
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Steiner
authors.forename: Edward
authors.initials: E
authors.lastname: Feldman
authors.forename: Amy
authors.initials: A
authors.lastname: Mann
authors.forename: James
authors.initials: J
authors.lastname: Mirocha
authors.forename: Itai
authors.initials: I
authors.lastname: Danovitch
authors.forename: Gil Y
authors.initials: GY
authors.lastname: Melmed
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000523:psychology*; D003863:Depression / Q000209:etiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000473:pathology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000523:psychology / Q000628:therapy; D008297:Male; D000071066:Patient Reported Outcome Measures; D011379:Prognosis; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires