Abstract
This study was designed to determine if a new condition-specific quality of life measure, the Quality Of Life in Reflux And Dyspepsia (QOLRAD), was responsive to clinical change over a four-week period when evaluating peptic ulcer disease patients undergoing Helicobacter pylori (Hp) eradication. A secondary aim was to evaluate QOLRAD's psychometric performance. Hp-positive patients with peptic ulcer disease were recruited from primary care and gastroenterology clinics (N = 155). QOLRAD scores improved significantly (P < 0.0001) and mean total score increase was 1.07 points on a 7-point scale among 111 subjects who responded to Hp eradication. Effect sizes were moderate for responders (0.64) and low for nonresponders (0.36). Score changes below 0.60 were associated with the smallest improvement in patient and physician condition rating; scores above 1.2 were associated with the greatest improvement. The QOLRAD demonstrates reliability and validity. Changes in QOLRAD score can be meaningfully related to clinical changes, aiding evaluation of health-related quality of life in peptic ulcer disease.
Similar content being viewed by others
REFRENCES
NIH Consensus Development Panel on Helicobacter pylori in Peptic Ulcer Disease: Helicobacter pylori in peptic ulcer disease. JAMA 272:65–69, 1994
Sonnenberg A, Everhart JE: Health impact of peptic ulcer in the United States. Am J Gastroenterol 92:614–620, 1997
Marshall BJ, Warren JR: Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1(8336):1273–1275, 1984
Soll AH: Consensus conference. Medical treatment of peptic ulcer disease. Practice guidelines. Practice Parameters Committee of the American College of Gastroenterology. JAMA 275:622–629, 1996
Levenstein S, Ackerman S, Kiecolt-Glaser JK, Dubois A: Stress and peptic ulcer disease. JAMA 281:10–11, 1999
Blum AL, Talley NJ, O'Morain C, van Zanten SV, Labenz J, Stolte M, Louw JA, Stubberod A, Theodors A, Sundin M, Bolling-Sternevald E, Junghard O: Lack of effect of treating Helicobacter pylori infection in patients with nonulcer dyspepsia. N Engl J Med 339:1875–1881, 1998
Lazzaroni M, Bargiggia S, Sangaletti O, Maconi G, Boldorini M, Bianchi Porro G: Eradication of Helicobacter pylori and long-term outcome of functional dyspepsia. A clinical endoscopic study. Dig Dis Sci 41:1589–1594, 1996
Holtmann G, Goebell H, Holtmann M, Talley NJ: Dyspepsia in healthy blood donors. Pattern of symptoms and association with Helicobacter pylori. Dig Dis Sci 39:1090–1098, 1994
Martin C, Marquis P, Bonfils S: A 'quality of life questionnaire' adapted to duodenal ulcer therapeutic trials. Scand J Gastroenterol 29(suppl 206):40–43, 1994
Shaw M, Talley NJ, Adlis S, Beebe T, Tomshine P, Healey M: Development of a digestive health status instrument: Tests of scaling assumptions, structure and reliability in a primary care population. Aliment Pharmacol Ther 12:1067–1078, 1998
Cutts TF, Abell TL, Karas JG, Kuns J: Symptom improvement from prokinetic therapy corresponds to improved quality of life in patients with severe dyspepsia. Dig Dis Sci 41:1369–1378, 1996
Moyer CA, Fendrick AM: Measuring health-related quality of life in patients with upper gastrointestinal disease. Dig Dis 16:315–324, 1998
Wiklund IK, Junghard O, Grace E, Talley NJ, Kamm M, Veldhuyzen van Zanten S, Pare P, Chiba N, Leddin DS, Bigard M-A, Colin R, Schoenfeld P: Quality of life in reflux and dyspepsia patients. Psychometric documentation of a new disease-specific questionnaire (QOLRAD). Eur J Surg Suppl 583:41–49, 1998
Svedlund J, Sjodin I, Dotevall G: GSRS-a clinical rating scale for gastrointestinal symptoms in patients with IBS and peptic ulcer disease. Dig Dis Sci 33:129–134, 1988
Dimenäs E, Glise H, Hallerbäck B, Hernqvist H, Svedlund J, Wiklund I: Well-being and gastrointestinal symptoms among patients referred to endoscopy owing to suspected duodenal ulcer. Scand J Gastroenterol 30:1046–1052, 1995
Dimenäs E, Glise H, Hallerbäck B, Hernqvist H, Svedlund J, Wiklund I: Quality of life in patients with upper gastrointestinal symptoms. An improved evaluation of treatment regimens? Scand J Gastroenterol 28:681–687, 1993
Revicki DA, Wood M, Wiklund I, Crawley J: Reliability and validity of the gastrointestinal symptom rating scale in patients with gastroesophageal reflux disease. Qual Life Res 7:75–83, 1998
Guyatt GH, Deyo RA, Charlson M, Levine MN, Mitchell A: Responsiveness and validity in health status measurement: A clarification. J Clin Epidemiol 42:403–408, 1989
Lydick EG, Epstein RS: Clinical significance of quality of life data. In Quality of Life and Pharmacoeconomics in Clinical Trials. B Spilker (ed). Philadelphia, Lippincott-Raven Publishers, 1996, pp 461–466
Kazis LE, Anderson JJ, Meenan RF: Effect sizes for interpreting changes in health status. Med Care 27(suppl 3):S178–S189, 1989
Katz JN, Gelberman RH, Wright EA, Lew RA, Liang MH: Responsiveness of self-reported and objective measures of disease severity in carpal tunnel syndrome. Med Care 32:1127–1133, 1994
Cohen J: Statistical Power Analyses for the Behavioral Sciences, 2nd ed. Hillsdale, New Jersey, Erlbaum, 1988
Jachuck SJ, Brierley H, Jachuck S, Wilcox PM: The effect of hypotensive drugs on the quality of life. J R Coll Gen Pract 32(235):103–105, 1982
Mant JWF, Jenkinson C, Murphy MFG, Clipsham K, Marshall PO, Vessey MP: Use of the Short Form-36 to detect the influence of upper gastrointestinal disease on self-reported health status. Qual Life Res 7:221–226, 1998
Dimenäs E: Methodological aspects of evaluation of quality of life in upper gastrointestinal diseases. Scand J Gastroenterol 23(suppl 199):18–21, 1993
Wiklund I, Butler-Wheelhouse P: Psychosocial factors and their role in symptomatic gastroesophageal reflux disease and functional dyspepsia. Scand J Gastroenterol 31(suppl 220): 94–100, 1996
Dimenäs E, Carlsson G, Glise H, Israelsson B, Wiklund I: Relevance of norm values as part of the documentation of quality of life instruments for use in upper gastrointestinal disease. Scand J Gastroenterol 31(suppl 221):8–13, 1996
Wilhelmsen I: Quality of life and Helicobacter pylori eradication. Scand J Gastroenterol 31(suppl 221):18–20, 1996
Shaw MJ, Adlis SA, Beebe TJ, Talley NJ, Kane RL: When does simple heartburn become a disease? Digestive Disease Week, May 1999; Orlando, Florida. Gastroenterology 116(4):A-956, 1999 (abstract)
Garrat AM, Ruta DA, Russell I, Macleod K, Brunt P, McKinlay A, Mowat A, Sinclair T: Developing a conditionspecific measure of health for patients with dyspepsia and ulcer-related symptoms. J Clin Epidemiol 49:565–571, 1996
Drossman DA, Funch-Jensen P, Janssens J, Talley NJ, Thompson WG, Whitehead WE: Identification of subgroups of functional gastrointestinal disorders. Gastroenterol Int 3:159–172, 1990
Fendrick AM, Chernew ME, Hirth RA, Bloom BS: Alternative management strategies for patients with suspected peptic ulcer disease. Ann Intern Med 123:260–268, 1995
Rights and permissions
About this article
Cite this article
Crawley, J., Frank, L., Joshua-Gotlib, S. et al. Measuring Change in Quality of Life in Response to Helicobacter pylori Eradication in Peptic Ulcer Disease. Dig Dis Sci 46, 571–580 (2001). https://doi.org/10.1023/A:1005655317121
Issue Date:
DOI: https://doi.org/10.1023/A:1005655317121