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J Crohns Colitis. 2018 Apr 27;12(5):600-609. doi: 10.1093/ecco-jcc/jjy024.

Burden of Ulcerative Colitis on Functioning and Well-being: A Systematic Literature Review of the SF-36® Health Survey.

Author information

Optum, Johnston, RI, USA.
University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, IL, USA.
Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain.
Centre for Immunobiology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Department of Gastroenterology, University Hospitals Leuven, Leuven, Belgium.
Pfizer Inc, Groton, CT, USA.
New York University School of Medicine, New York, NY, USA.
Pfizer Inc, New York, NY, USA.


Background and Aims:

This review is the first to evaluate the burden of ulcerative colitis [UC] on patients' quality of life by synthesizing data from studies comparing scores from the SF-36® Health Survey, a generic measure assessing eight quality-of-life domains, between UC patients and matched reference samples.


A systematic review of the published literature identified articles reporting SF-36 domains or physical and mental component summary scores [PCS, MCS] from UC and reference samples. Burden of disease for each SF-36 domain was then summarized across studies by comparing weighted mean differences in scores between patient and reference samples with minimally important difference thresholds.


Thirty articles met pre-specified inclusion criteria. SF-36 scores were extracted from five samples of patients with active disease, 11 samples with a mixture of disease activity, five samples of patients in clinical remission, and 13 samples of patients following proctocolectomy with ileostomy or ileal pouch-anal anastomosis, along with respective reference samples. Clinically meaningful burden was observed in samples with active or mixed disease activity [deficits: PCS = 5.6, MCS = 5.5] on all SF-36 domains except Physical Functioning. No burden was observed in samples in remission or post-surgical patients [deficits: PCS = 0.8, MCS = 0.4] except for the General Health perception domain.


Patients with active UC experience a clinically meaningful burden of disease across most aspects of quality of life. Patients with inactive UC exhibit negligible disease burden and are comparable to the general population on most quality-of-life outcomes. Thus, treatments which effectively induce and maintain remission may restore physical and mental health status.

[Indexed for MEDLINE]

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