Concordance and Discordance Between Patient-reported Remission, Patient-reported Outcomes, and Physician Global Assessment
Author:
Kamp Kendra J1ORCID, Hawes Stephen E1, Tse Chung Sang2, Singh Siddharth2ORCID, Dang Nhu3, Oberai Ridhima4, Weaver S Alandra4, Melmed Gil Y5, Siegel Corey A6, van Deen Welmoed K7, Younes Ziad, Mattar Mark C, Metwally Mark, Scott Frank, Ostrov Arthur, Rubin David T, Gerich Mark, Gerner Donna, Heagy Erica, Nelson Eugene, Holthoff Megan, Hudesman David, Oberai Ridhima, Almario Christopher, Bray Harry, Crate Damara, Hou Jason K, Singh Siddharth, Arrieta Rose, Banty Andrea, Betteridge John, Carron Jessica, Charabaty Aline, Danielewicz Michael, Deitch Josh, Farraye Francis, Fasanya Helen, Flynn Ann, Ha Christina, Kaufman Lia, Kaur Nirmal, Kearney Kristi, Kennedy Alice M, Kim Betty, Kwon Michelle, Le Helen, Mize Carrie, Morgan Emily, Morris-McCoy Linda, Oonk Alexis, Pashby Teresa, Rai Victoria, Reddy Swapna, Roake Kami, Shukla Richa, Syal Gaurav, Traboulsi Cindy, Turner Quin, Valentine John, Vrabie Raluca, Walker Trisha, Weatherly Julie, Williams Emmanuelle, Yun Laura, Zisman Tim,
Affiliation:
1. University of Washington , Seattle, WA , United States 2. University of California - San Diego , San Diego , CA , United States 3. Brown University , Providence, RI , United States 4. Crohn’s and Colitis Foundation , New York, NY , United States 5. Cedars-Sinai Medical Center , Los Angeles, CA , United States 6. Dartmouth-Hitchcock Medical Center , Hanover, NH , United States 7. Erasmus School of Health Policy and Management , Rotterdam , the Netherlands
Abstract
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 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.
Funder
National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases University of Washington
Publisher
Oxford University Press (OUP)
Subject
Gastroenterology,Immunology and Allergy
Cited by
2 articles.
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