Concordance and Discordance Between Patient-reported Remission, Patient-reported Outcomes, and Physician Global Assessment.

Autor:	Kamp KJ; University of Washington, Seattle, WA, United States., Hawes SE; University of Washington, Seattle, WA, United States., Tse CS; University of California - San Diego, San Diego, CA, United States., Singh S; University of California - San Diego, San Diego, CA, United States., Dang N; Brown University, Providence, RI, United States., Oberai R; Crohn's and Colitis Foundation, New York, NY, United States., Weaver SA; Crohn's and Colitis Foundation, New York, NY, United States., Melmed GY; Cedars-Sinai Medical Center, Los Angeles, CA, United States., Siegel CA; Dartmouth-Hitchcock Medical Center, Hanover, NH, United States., van Deen WK; Erasmus School of Health Policy and Management, Rotterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	Inflammatory bowel diseases [Inflamm Bowel Dis] 2023 Aug 01; Vol. 29 (8), pp. 1255-1262.
DOI:	10.1093/ibd/izac206
Abstrakt:	Background: Although validated patient-reported outcome (PRO) measurements can categorize patients with inflammatory bowel disease (IBD) into clinical remission or active disease, patients may have different definitions of remission. The purpose of this study was to compare patient-defined remission to remission based on PRO measures and physician global assessment (PGA) and to understand the clinical and demographic factors associated with disagreements. Methods: We retrospectively analyzed 3257 de-identified surveys from 2004 IBD patients who consented to participate in the Crohn's and Colitis Foundation's IBD Qorus Learning Health System between September 2019 and February 2021. We used logistic regression models with generalized estimating equations to analyze the clinical and demographic factors (eg, age, disease duration, health confidence) associated with discordance between patient-defined remission (yes/no) and PRO-defined remission for ulcerative colitis (UC; PRO2: stool frequency, rectal bleeding) and Crohn's disease (CD; PRO-3: average number of liquid stools, abdominal pain, well-being). Results: Among patients with UC, overall concordance was 79% between patient self-report and PRO2-defined remission and 49% between patient self-report and PGA-defined remission. Among patients with CD, overall concordance was 69% between patient self-report and PRO3-defined remission and 54% between patient self-report and PGA-defined remission. Patients in PRO-defined remission were more likely to report active disease if they had IBD <5 years and low health confidence. Patients with PRO-defined active disease were more likely to report remission if they were not using prednisone and had high health confidence. Conclusion: Discordance exists between how remission is defined by patients, PRO measures, and PGA. (© The Author(s) 2022. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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