P005 A multi-marker serum test to assess the presence of ulcerations in infliximab treated patients with Crohn’s disease
Notice bibliographique
Résumé
Resolution of ulcerations is an important component of mucosal healing (MH) in Crohn’s disease (CD) that is typically assessed with ileocolonoscopy, although this is an invasive, expensive and uncomfortable procedure. A non-invasive and accurate multi-marker serum test yielding a mucosal healing index (MHI) score in CD patients has recently been developed and validated based on the CD endoscopic index of severity. The aim of this study was to assess the clinical utility of the multi-analyte MH algorithm in two independent real-life cohorts of CD patients under infliximab (IFX). In cohort 1 (n = 104, median age 36.5 years, 58% female, 11% ileal disease, 25% colonic disease, 64% ileocolonic disease), cross-sectional serum samples were obtained after a median of 32 weeks post-IFX. In cohort 2 (n = 65, median age 36.1 years, 58% female, 11% ileal disease, 20% colonic disease, 69% ileocolonic disease), consecutive serum samples were taken within 20 days before start of IFX and after a median of 23 weeks post-IFX. All serum samples were taken within 30 days of ileocolonoscopy. At time of ileocolonoscopy, complete MH, partial MH and no MH were defined as absence of ulcerations, ≥50% endoscopic improvement but with ulcerations still present, and no endoscopic improvement, respectively. The MH index (MHI) was constructed based on 13 markers and ranged from 0–100. Non-parametric tests were performed and the established cut-offs of MHI ≤ 40 (low endoscopic disease activity) and MHI ≥ 41 (medium to high endoscopic disease activity) were used. p-values of <0.05 were considered significant. In cohort 1, 42.3% of the patients had no MH, 18.3% had partial MH and 39.4% had complete MH after IFX. MHI scores were significantly lower in patients with complete MH compared with patients with partial (p = 0.049) and no (p < 0.001) MH who still had ulcerations post-IFX. Moreover, 78% of patients with MHI scores ≥41 had ulcerations post-IFX. In cohort 2, 34% of the patients had no MH, 32% had partial MH and 34% had complete MH post-IFX. No significant differences in MHI scores were found at baseline, whereas MHI scores were significantly lower in patients with complete MH compared with patients without MH post-IFX (p = 0.009). 88% of patients with MHI scores ≥41 had persistent ulcerations post-IFX. The MHI decreased in 85% of the patients post-IFX, but in 80% of the patients with an increased MHI persistent ulcerations were observed. We validated the clinical utility of the MHI for the assessment of ulcerations in CD patients in two independent real-life cohorts. This novel non-invasive test will be a useful tool to monitor MH in CD patients and help avoid unnecessary repetitive endoscopic evaluations.
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 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
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 ».