Patient-Reported Outcome Measures Poorly Correlate with Objective Inflammatory Bowel Disease Activity Measures: A Systematic Review.

Background and aims: We investigated the correlations between patient-reported outcome measures (PROMs) and other measures of inflammatory bowel disease (IBD) activity.

Methods: A systematic literature review was performed up to June 2022. Searches were conducted in PubMed, Scopus and Web of Science. A descriptive analysis was performed. The search protocol was registered in PROSPERO (CRD42022383899).

Results: Nineteen studies assessed correlations between PROMs and clinical, endoscopic, and laboratory measures of disease activity in IBD. In Crohn's disease (CD), weak positive correlations were reported for PROMs (e.g. the two-item patient reported outcome [PRO-2], mobile Health Index [mHI] for CD) and endoscopic scores, more often the Simple Endoscopic Score for CD (SES-CD). In ulcerative colitis (UC), PROMs like PRO-2, the Monitor IBD at Home rectal bleeding item and the mHI, showed weak-to-moderate correlations with the Mayo endoscopic subscore (MES). PROMs also demonstrated limited concordance with laboratory measures such as faecal calprotectin (FCP) and C-reactive protein (CRP) in both CD and UC. The substantial heterogeneity in study designs precluded a structured analysis.

Conclusions: Although current PROMs offer valuable complementary insights into IBD control from the patient's perspective, they cannot replace objective measures of IBD activity. Future research should focus on refining PROMs and generating composite indices to improve their accuracy and usefulness.