Irvine E J, Zhou Q, Thompson A K
Department of Medicine, McMaster University, Hamilton, Ontario.
Am J Gastroenterol. 1996 Aug;91(8):1571-8.
Health-related quality of life (HRQOL) affects outcome in chronic diseases such as inflammatory bowel disease (IBD). The inflammatory bowel disease questionnaire (IBDQ), a disease-specific HRQOL questionnaire, can define changes in health status in IBD, but simple instruments are needed for daily application. The present study proposed to develop a short version of the IBDQ, the SIBDQ, for community physicians.
Using data from a clinical trial in 149 patients with Crohn's disease, 10 items were selected (by forward stepwise regression) that best explained the variance of the IBDQ or dimensional scores (bowel, systemic, social, emotional). The validity, reliability, and responsiveness of the SIBDQ were then assessed in 150 different patients with Crohn's disease and 45 with ulcerative colitis. All scores were reported with a 7-point scale (1 = poor HRQOL, 7 = optimum HRQOL).
Mean SIBDQ scores were similar (p = 0.22) in Crohn's patients among 14 participating centers at study entry. Mean scores were lower in active Crohn's disease (range 4.00-4.92) than inactive disease (range 4.67-5.83; p = 0.0015). In active ulcerative colitis, the mean SIBDQ was 4.79 +/- 1.17 compared to 5.90 +/- 0.80 (p = 0.0006) in inactive disease. The SIBDQ explained 92% and 90% of the IBDQ variance in Crohn's disease and ulcerative colitis, respectively. In patients with stable Crohn's disease, the test-retest reliability coefficient was 0.65 and Crohnbach's alpha was 0.78, indicating good reliability. In patients with Crohn's disease who relapsed during follow-up, the mean SIBDQ decreased by -0.93 + 0.55 (p = 0.001).
The SIBDQ is valid, reliable, and able to detect meaningful clinical changes in HRQOL that might occur in the office setting.
健康相关生活质量（HRQOL）会影响炎症性肠病（IBD）等慢性病的预后。炎症性肠病问卷（IBDQ）是一种针对特定疾病的HRQOL问卷，可界定IBD患者健康状况的变化，但日常应用需要简单的工具。本研究旨在为社区医生开发一种IBDQ的简短版本，即SIBDQ。
利用一项针对149例克罗恩病患者的临床试验数据，通过向前逐步回归选择了10个能最好解释IBDQ或维度得分（肠道、全身、社会、情感）方差的项目。随后在150例不同的克罗恩病患者和45例溃疡性结肠炎患者中评估了SIBDQ的有效性、可靠性和反应性。所有得分均采用7分制（1 = HRQOL差，7 = HRQOL最佳）。
在研究开始时，14个参与中心的克罗恩病患者的SIBDQ平均得分相似（p = 0.22）。活动期克罗恩病的平均得分（范围4.00 - 4.92）低于非活动期疾病（范围4.67 - 5.83；p = 0.0015）。在活动期溃疡性结肠炎中，SIBDQ平均分为4.79±1.17，而非活动期疾病为5.90±0.80（p = 0.0006）。SIBDQ分别解释了克罗恩病和溃疡性结肠炎中IBDQ方差的92%和90%。在病情稳定的克罗恩病患者中，重测信度系数为0.65，克朗巴赫α系数为0.78，表明可靠性良好。在随访期间复发的克罗恩病患者中，SIBDQ平均分下降了-0.93 + 0.55（p = 0.001）。
SIBDQ有效、可靠，能够检测在门诊环境中可能发生的HRQOL有意义的临床变化。
