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NON-FINANCIAL COSTS


When people with IBD receive effective treatment, their quality of life can approach that of the general population. A study in UC patients measured the change in quality of life using the SF-36.135


Study subjects who experienced remission with treatment had quality of life


improvements that restored them to typical levels of quality of life, while those who did not respond had minimal improvement. In between these groups, the patients who had some response (but not a remission) had an intermediate improvement in quality of life (see Figure 2).


Figure 2: Mean Change in SF-36 Summary and Individual Scale Scores from Baseline to Week 30 by Response Status


UTILITY Utility Scores


A third type of quality of life questionnaire is known as a utility instrument. This is a generic quality of life questionnaire, because it can be given to anyone. It has two extra features: first, the resulting score is a single number making comparisons easy (in contrast, the SF-36 gives a set of scores for each of the eight different aspects of quality of life that it measures); and second, the score has a specific meaning. The utility score is assigned with reference to a top and a bottom score. A top score of 1 is a state of perfect health. A bottom score of 0 is a state of death. Different diseases have scores in between 0 and 1, depending on how strongly people feel they would prefer one disease compared to another. For example, the average utility score for the US population is 0.85 – reflecting a mix of people and states of health, some good and some bad.137


People with IBD score below the US average, even when they are in a state of remission. Only a few studies have used utility instruments in IBD, but they have found consistent results.138,139 People with moderate to severe disease scored very low at 0.45, which indicates a very significant impairment in quality of life. People with mild disease scored at 0.68, typical of


THE IMPACT OF INFLAMMATORY BOWEL DISEASE IN CANADA 73


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