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      Real-time data monitoring for ulcerative colitis: patient perception and qualitative analysis

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          Abstract

          Background/Aims

          TrueColours ulcerative colitis (TCUC) is a comprehensive web-based program that functions through email, providing direct links to questionnaires. Several similar programs are available, however patient perspectives are unexplored.

          Methods

          A pilot study was conducted to determine feasibility, usability and patient perceptions of real-time data collection (daily symptoms, fortnightly quality of life, 3 monthly outcomes). TCUC was adapted from a web-based program for patients with relapsing-remitting bipolar disorder, using validated UC indices. A semi-structured interview was developed and audio-recorded face-to-face interviews were conducted after 6 months of interaction with TCUC. Transcripts were coded in NVivo11, a qualitative data analysis software package. An inductive approach and thematic analysis was conducted.

          Results

          TCUC was piloted in 66 patients for 6 months. Qualitative analysis currently defies statistical appraisal beyond “data saturation,” even if it has more influence on clinical practice than quantitative data. A total of 28 face-to-face interviews were conducted. Six core themes emerged: awareness, control, decision-making, reassurance, communication and burden of treatment. There was a transcending overarching theme of patient empowerment, which cut across all aspects of the TCUC experience.

          Conclusions

          Patient perception of the impact of real-time data collection was extremely positive. Patients felt empowered as a product of the self-monitoring format of TCUC, which may be a way of improving self-management of UC whilst also decreasing the burden on the individual and healthcare services.

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          Most cited references33

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          Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 1: Definitions, Diagnosis, Extra-intestinal Manifestations, Pregnancy, Cancer Surveillance, Surgery, and Ileo-anal Pouch Disorders.

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            A simple clinical colitis activity index.

            The appropriate medical treatment of patients with ulcerative colitis is determined largely by the severity of symptoms. Hospital assessment of the severity of disease activity includes investigation of laboratory indices and sigmoidoscopic assessment of mucosal inflammation. To develop a simplified clinical colitis activity index to aid in the initial evaluation of exacerbations of colitis. The information for development of the simple index was initially evaluated in 63 assessments of disease activity in patients with ulcerative colitis where disease activity was evaluated using the Powell-Tuck Index (which includes symptoms, physical signs, and sigmoidoscopic appearance). The new index was then further evaluated in 113 assessments in a different group of patients, by comparison with a complex index utilising clinical and laboratory data, as well as five haematological and biochemical markers of disease severity. The newly devised Simple Clinical Colitis Activity Index, consisting of scores for five clinical criteria, showed a highly significant correlation with the Powell-Tuck Index (r = 0.959, p < 0.0001) as well as the complex index (r = 0.924, p < 0.0001) and all laboratory markers (p = 0.0003 to p < 0.0001). This new Simple Colitis Activity Index shows good correlation with existing more complex scoring systems and therefore could be useful in the initial assessment of patients with ulcerative colitis.
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              Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research.

              C Pope, N Mays (1995)
              Qualitative research methods have a long history in the social sciences and deserve to be an essential component in health and health services research. Qualitative and quantitative approaches to research tend to be portrayed as antithetical; the aim of this series of papers is to show the value of a range of qualitative techniques and how they can complement quantitative research.
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                Author and article information

                Journal
                Intest Res
                Intest Res
                IR
                Intestinal Research
                Korean Association for the Study of Intestinal Diseases
                1598-9100
                2288-1956
                July 2019
                31 May 2019
                : 17
                : 3
                : 365-374
                Affiliations
                [1 ]Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
                [2 ]Linacre College, University of Oxford, Oxford, UK
                [3 ]Big Data Institute, University of Oxford, Oxford, UK
                [4 ]Department of Psychiatry, University of Oxford, Oxford, UK
                [5 ]Centre for Statistics in Medicine, University of Oxford, Oxford, UK
                [6 ]Nuffield Department of Population Health, University of Oxford, Oxford, UK
                Author notes
                Correspondence to Alissa Walsh, Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford OX3 9DU, UK. Tel: +44-7495920267, E-mail: alissa.walsh@ 123456ouh.nhs.uk
                Author information
                http://orcid.org/0000-0002-8994-1186
                Article
                ir-2018-00173
                10.5217/ir.2018.00173
                6667366
                31146510
                fe9fbe6b-d1c8-46c2-b96b-4bb28892d352
                © Copyright 2019. Korean Association for the Study of Intestinal Diseases. All rights reserved.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 January 2019
                : 29 March 2019
                : 30 April 2019
                Categories
                Original Article
                Inflammatory Bowel Diseases

                electronic data processing,colitis, ulcerative,perception

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