P521 Correlation between physician disease assessment in Ulcerative Colitis and burden of disease: ICONIC 2-year data of 120 patients in Turkey

Sezgin, O.(1);Atug, O.(2);Gonen, C.(3);Can, G.(4);Duman, A.E.(5);Erzin, Y.Z.(6);Yurci, M.A.(7);Alkim, C.(8);Unal Ozcelik, N.G.(9);Yildirim, B.(10);Kayacetin, E.(11);Beyazit, Y.(12);Tayfur Yurekli, O.(11);Kiyici, M.(13);

(1)Mersin University - Faculty of Medicine Department of General Surgery, Department of Gastroenterology, Mersin, Turkey;(2)Marmara University Medical Faculty Training and Research Hospital, Institute of Gastroenterology, Istanbul, Turkey;(3)Acibadem Mehmet Ali Aydinlar University- School of Medicine, Department of Gastroenterology, Istanbul, Turkey;(4)Bolu Abant İzzet Baysal University İzzet Baysal Training and Research Hospital- School of Medicine, Department of Gastroenterology, Bolu, Turkey;(5)Kocaeli University- School of Medicine, Department of Gastroenterology, Kocaeli, Turkey;(6)Istanbul University-Cerrahpasa, Department of Gastroenterology, Istanbul, Turkey;(7)Erciyes University- School of Medicine, Department of Gastroenterology, Kayseri, Turkey;(8)Sisli Hamidiye Etfal Training and Research Hospital, Department of Gastroenterology, Istanbul, Turkey;(9)Ege University Medical Faculty Hospital, Department of Gastroenterology, İzmir, Turkey;(10)Ondokuz Mayıs University- School of Medicine, Department of Gastroenterology, Samsun, Turkey;(11)Ankara City Hospital, Department of Gastroenterology, Ankara, Turkey;(12)Canakkale 18 Mart University Health Research and Application Center, Department of Gastroenterology, Canakkale, Turkey;(13)Uludag University- School of Medicine, Department of Gastroenterology, Bursa, Turkey


Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD), and the overall burden is increasing at the global level. Differences in perceptions of UC-related burden may highlight dramatic degree insufficient patient-physician communication. ICONIC is a prospective, non-interventional, observational study assessing disease burden in adults with UC using Pictorial Representation of Illness and Self Measure (PRISM). The local results of ICONIC study for Turkey are presented.


Patients aged ≥18 years with early UC (diagnosed ≤36 months) were enrolled. At baseline and every 6 months, patient and physician reported outcomes were collected using PRISM, the Simple Clinical Colitis Activity Index (SCCAI and P-SCCAI), The Rating Form of IBD Patients’ Concerns (RFIPC), the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), and the Patient Health Questionnaire-9 (PHQ-9). Correlations between the patient assessed PRISM and other measurement tools were evaluated with Pearson correlation coefficient.


One hundred and twenty patients were included (77 [64.2%] female; mean age 35.2 years). Physician-assessed disease severity was: severe 23 [19.2%], moderate 42 [35.0%], mild 40 [33.3%], in remission 15 [12.5%]. The mean ± SD physician- and patient-assessed PRISM scores were 4.8 ± 2.3 cm (range: 0.0-9.0) and 4.1 ± 2.6 cm (range: 0.0-8.5) at baseline and increased to 6.1 ± 2.3 cm (range: 0.1-8.5) and 5.5 ± 2.7 cm (range: 0.0-9.3) at the final visit, respectively, indicating an improvement in the perceived disease burden. The mean values of physician-SCCAI and P-SCCAI were 3.8 ± 3.5 and 5.5 ± 4.3 at baseline and decreased to 1.4 ± 2.5 and 2.7 ± 3.2 at the final visit, respectively, showing a decrease in disease activity. At baseline, the RFIPC and PHQ-9 values were 2.7 ± 1.7 and 8.0 ± 5.5 and decreased to 2.2 ± 2.0 and 5.2 ± 4.5 at the final visit, respectively. Patient-assessed SIBDQ was 43.8 ± 14.5 at baseline and increased to 54.0 ± 13.0 at the final visit. The strongest correlation of patient-assessed PRISM was with the physician-assessed PRISM (Spearman rho = 0.69, p<0.0001), followed by SCCAI (rho = ‑0.56, p<0.0001). Differences between physician- and patient-assessed PRISM scores were statistically significant (baseline: p=0.0010 vs. final visit: p=0.0206), highlighting an underestimation of patient’s suffering by physicians.


In the Turkish ICONIC sub-study, majority of patients on treatment showed improved outcomes during the follow-up period. A moderate correlation between patient-assessed PRISM and other measurement instruments represents that PRISM may be used as surrogate marker for patient suffering.