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Author Notes:

Correspondence: Brennan Spiegel, MD, MSHS, VA Greater Los Angeles Healthcare System/UCLA, Digestive Diseaes, 11301 Wilshire Blvd, Building 11, Room 21E, Los Angeles, California 90073, USA. bspiegel@mednet.ucla.edu.

Spiegel and Chang formulated the hypotheses and aims of the study, wrote the study protocol, and prepared the manuscript.

Spiegel carried out the analyses in concert with Chang and Bolus.

Chang, Chey, Dulai, Esrailian, Harris, Karsan, Lembo, Lucak, Talley, and Tillisch assisted with patient recruitment and review of the manuscript.

Naliboff and Mayer provided intellectual input to the manuscript.

The opinions and assertions contained in this article are the sole views of the authors and are not to be construed as official or as reflecting the views of the Department of Veterans Affairs.

Brennan Spiegel is a consultant for Prometheus, Takeda, McNeil, and Rose Pharmaceuticals.


Research Funding:

Spiegel is supported by a Veteran’s Affairs Health Services Research and Development Career Development Award (RCD 03-179-2), and the CURE Digestive Disease Research Center (NIH 2P30 DK 041301-17).

Chang, Naliboff, and Mayer are supported by NIH grant no. P50 DK64539, and Spiegel, Mayer, and Naliboff are supported by NIH Center Grant 1 R24 AT002681-NCCAM from the UCLA Center for Neurobiology of Stress.

Brennan Spiegel received grant support from Takeda.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Gastroenterology & Hepatology

Developing Valid and Reliable Health Utilities in Irritable Bowel Syndrome: Results From the IBS PROOF Cohort

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Journal Title:

American Journal of Gastroenterology


Volume 104, Number 8


, Pages 1984-1991

Type of Work:

Article | Post-print: After Peer Review


OBJECTIVES: A utility is a measure of health-related quality of life (HRQOL) that ranges between 0 (death) and 1 (perfect health). Disease-targeted utilities are mandatory to conduct cost-utility analyses. Given the economic and healthcare burden of irritable bowel syndrome (IBS), cost-utility analyses will play an important role in guiding health economic decision-making. To inform future cost-utility analyses in IBS, we measured and validated the IBS utilities.METHODS:We analyzed data from Rome III IBS patients in the Patient Reported Observed Outcomes and Function (PROOF) Cohorta longitudinal multi-center IBS registry. At entry, the patients completed a multi-attribute utility instrument (EuroQOL), bowel symptom items, IBS severity measurements (IBS Severity Scale (IBSSS), Functional Bowel Disease Severity Index (FBDSI)), HRQOL indexes (IBS quality-of-life instrument (IBS-QOL), Center for disease control-4 (CDC-4)), and the Worker Productivity Activity Index for IBS (WPAI). We repeated assessments at 3 months.RESULTS:There were 257 patients (79% women; age43±15 years) at baseline and 85 at 3 months. The mean utilities in patients with severe vs. non-severe IBS were 0.70 and 0.80, respectively (P < 0.001). There were no differences in utilities among IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), and mixed IBS (IBS-M) subgroups. EuroQOL utilities correlated with FBDSI (r0.31; P<0.01), IBSSS (r0.36; P<0.01), IBS-QOL (r0.36; P<0.01), CDC-4 (r0.44; P<0.01), WPAI presenteeism (r0.16; P<0.01), abdominal pain (r0.43; P<0.01), and distension (r0.18; P<0.01). The utilities in patients reporting considerable relief of symptoms at 3 months vs. those without considerable relief were 0.78 and 0.73, respectively (P<0.02).CONCLUSIONS:EuroQOL utilities are valid and reliable in IBS. The utility of severe IBS (0.7) is similar to Class III congestive heart failure and rheumatoid arthritis. These validated utilities can be employed in future IBS cost-utility analyses.

Copyright information:

© 2009 by the American College of Gastroenterology.

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