Share this article on:

Correlation of Health-Related Quality of Life in Children With Inflammatory Bowel Disease, Their Parents, and Physician as Measured by a Visual Analog Scale

Teitelbaum, Jonathan E.*; Rajaraman, Rajsekar R.*; Jaeger, Joseph*; Para, Sindhu; Rakitt, Tina*

Journal of Pediatric Gastroenterology and Nutrition: November 2013 - Volume 57 - Issue 5 - p 594–597
doi: 10.1097/MPG.0b013e31829cf923
Original Articles: Gastroenterology

Background and Aims: Inflammatory bowel disease has been shown to affect children's health-related quality of life (HRQOL) through the use of lengthy questionnaires. We examined whether a pediatric patient's HRQOL, measured by a rapid visual analog scale (“feeling thermometer”), correlates with the perceptions of the HRQOL as determined by the patient's pediatric gastroenterologist and parent(s). Additionally, we attempted to determine whether the HRQOL correlates with the patient's disease activity as determined by validated activity indices.

Methods: A cross-sectional study of pediatric patients (ages 7–21 years) who were diagnosed as having Crohn disease, ulcerative colitis, or indeterminate colitis was conducted from January 2011 to May 2011. Each participant (patient, parent(s), and treating pediatric gastroenterologist) completed feeling thermometers to determine the symptom burden as well as therapeutic burden of the patient. The parent(s) and doctor were blinded to the patient's results. Pediatric Ulcerative Colitis Activity Index or a Short Pediatric Crohn Disease Activity Index (S-PCDAI) was calculated. Correlations between the participant's perceived burdens as well as their calculated disease activity were determined.

Results: Sixty-seven children and their families participated, resulting in 101 visits. Patients had a mean age of 15.0 years, and there were 38 boys. There was a strong significant correlation between the patient's perceived symptom burden and that of the parent's (ρ 0.59, P < 0.001) and physician (ρ 0.48, P < 0.001). Similarly, there was a strong significant correlation between patient's perceived treatment burden and that of the parent treatment burden (ρ 0.49, P < 0.001) and, to a lesser degree, the physician (ρ 0.29, P < 0.003). The correlation coefficient was strongest between the physician's perception of the patient's symptom burden against the standard disease activity indices Pediatric Ulcerative Colitis Activity Index (ρ 0.69, P < 0.001) and Short Pediatric Crohn Disease Activity Index (ρ 0.65, P < 0.001).

Conclusions: The patient's HRQOL was highly correlated to both the physician's and parent's perceptions as well as their disease activity. The feeling thermometer is a quick, easy-to-use, visual analog scale that can be implemented in everyday practice to measure a pediatric patient's HRQOL.

*Pediatric Gastroenterology, Children's Hospital at Monmouth Medical Center, Long Branch, NJ

High school student, Long Branch, NJ.

Address correspondence and reprint requests to Jonathan E. Teitelbaum, MD, 300 Second Ave, Children's Hospital at Monmouth Medical Center, Long Branch, NJ 07740 (e-mail:

Received 21 October, 2012

Accepted 21 May, 2013

J.E.T. is a paid member of the Prometheus advisory board. The other authors report no conflicts of interest.

© 2013 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,