Temporal trends in radiologic tests performed at diagnosis in a cohort of children with inflammatory bowel disease (1983-2011)
Notice bibliographique
Résumé
Children with inflammatory bowel disease (IBD) undergo radiologic tests at diagnosis to determine disease extent, behaviour, and complications. Over the past three decades, novel radiologic modalities have been introduced including computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US). The objective of this study was to characterize the trends in radiologic investigations used within six months of diagnosis in children with inflammatory bowel disease. We retrospectively identified all children ≤ 17 years old diagnosed with IBD between 1983 and 2011 and followed at the Alberta Children's Hospital, the sole tertiary care pediatric center in southern Alberta. We recorded radiologic investigations performed within six months of diagnosis (barium enema, small bowel follow through [SBFT], CT, MRI, US). Temporal trends were evaluated using joinpoint regression analysis. Subjects were categorized into 5-year intervals by year of diagnosis. Between January 1983 and June 2011, 565 children were diagnosed with IBD (300 Crohn's disease, 219 ulcerative colitis, and 46 IBD-unclassified or indeterminate colitis). During 1983-1987, 33 (89%) and 26 (70%) subjects received a barium enema and SBFT, respectively. During 1988-1992, 25 (63%) and 33 (83%) subjects received a barium enema and SBFT, respectively. During 1993-1997, 29 (31%) and 79 (84%) subjects received a barium enema and SBFT, respectively. During 1998-2002, 12 (11%) and 91 (83%) subjects received a barium enema and SBFT, respectively. During 2003-2007, 9 (5%), 124 (74%), and 1 (1%) subjects received a barium enema, SBFT, and CT/MRI, respectively. During 2008-2011, 1 (1%), 78 (67%), 20 (17%), 19 (16%), and 70 (60%) subjects received a barium enema, SBFT, CT, MRI, and US, respectively. At diagnosis, no subjects received an US before 2008 and no subjects received a CT or MRI before 2003. During 1983-2011, the use of barium enema and SBFT within six months of diagnosis decreased significantly (annual percent change -11% and -0.4%, respectively). During 2008-2011, the use of CT decreased significantly (annual percent change - 14%) and the use of MRI increased significantly (annual percent change +32%). During 2008-2011, subjects with Crohn's disease were more likely to receive CT, MRI, or US at diagnosis than subjects without Crohn's disease (odds ratio 4.5, 95% CI 1.8-12.2). As the types of radiologic modalities used in IBD have increased over the past three decades with the introduction of MRI, US, and CT, the use of modalities involving radiation (barium enema, SBFT, and CT) has decreased, affirming the goal to minimize radiation exposure in children. Enhanced understanding of the unique roles of each modality will allow further reduction of radiation exposure and improved abilities to determine disease extent, behaviour, and complications at diagnosis.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».