OUTCOME MEASURES Primary outcome measure The primary outcome measure will be changes in the paediatric IBD-specific health-related quality of life (QOL) scores. QOL scores will be assessed at baseline, and 6-monthly over the 2-year follow-up period using the validated paediatric IBD QOL IMPACT questionnaire (Appendix 1). The IMPACT questionnaire was originally developed for use in paediatric IBD in Canada (14) and with minor adaptations, the questionnaire was subsequently validated in Canada ((15), the Netherlands (16), and the UK (17). The questionnaire consists of 35 questions measuring six quality of life domains (IBD symptoms, systemic symptoms, emotional functioning, social functioning, body image, and treatment/interventions) and utilizes a Likert scale to report the patient's answers. Responses are scored (from 0 to 4) and summed to give a total score (range 0 to 140). Higher scores represent better QOL.