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

IBD Qorus, Kendra J Kamp, Stephen E Hawes, Chung Sang Tse, Siddharth Singh, Nhu Dang, Ridhima Oberai, S Alandra Weaver, Gil Y Melmed, Corey A Siegel, Welmoed K van Deen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)
15 Downloads (Pure)

Abstract

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 IBDa<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.

Original languageEnglish
Pages (from-to)1255-1262
Number of pages8
JournalInflammatory Bowel Diseases
Volume29
Issue number8
Early online date30 Sept 2022
DOIs
Publication statusPublished - 1 Aug 2023

Bibliographical note

© The Author(s) 2022. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: [email protected].

Fingerprint

Dive into the research topics of 'Concordance and Discordance Between Patient-reported Remission, Patient-reported Outcomes, and Physician Global Assessment'. Together they form a unique fingerprint.

Cite this