P580 Improvement in disease activity is associated with less disability in a prospective study of paediatric transition patients with IBD
Notice bibliographique
Résumé
The transition from paediatric to adult healthcare in patients with inflammatory bowel disease (IBD) occurs at an important time in a child’s psychosocial development and can impact education, employment, social integration and result in significant disability. A structured transition may limit disability and reduce the impact of disability over time. Our aims were to assess the change in disability over time in paediatric transition patients, who underwent a structured transition, using the validated Inflammatory Bowel Disease Disability Index (IBD-DI) and to assess the responsiveness of this index to change. 59 patients (aged 18–25) that had recently transitioned to adult care at the University of Calgary, were identified from a cohort of 200 patients recruited to undertake the IBD-DI. A research coordinator administered the IBD-DI with a repeat assessment at 12 months. Demographic and clinical data including measures of disease activity were collected from participants as well as medical chart and database review. Baseline IBD-DI scores were compared using the Mann–Whitney-U test. The Wilcoxon signed rank test with calculation of an effect size and standardised response mean were used to analyse change in IBD-DI scores over time, in groups based on change in disease activity. Baseline mean IBD-DI scores for the 59 transition patients was 20.69 ± 13.19 (range 0 to 54.41) and did not differ significantly from 141 adult patients (mean age 41.39) with mean scores of 24.90 ± 14.18 (range 1.47 to 70.59) (p = 0.08.) 50 out of 59 participants completed the follow-up assessment at 12 months. Disease activity over time improved in 5 patients, worsened in 5 and were stable in 39 patients. One patient had missing disease index measures and clinical status could not be classified. There was a significant reduction in IBD-DI scores for those with clinical improvement (−17.94, ES >−1, p = 0.04) and a significant increase in IBD-DI scores in those that with clinical deterioration (+23.53, ES >1, p = 0.04). There was a reduction in the IBD-DI scores over the 12-month time period, in patients with stable disease activity, (−2.68, ES=0.20, p = 0.15), however, this was not statistically significant. Table 1. Mean change in IBD-DI and effect size based on whether disease improved, was stable or worsened. Transition patients have similar disability scores as compared with an adult cohort. There was a significant reduction in IBD-DI scores for those with clinical improvement. The IBD-DI demonstrates significant responsiveness to changes in disease activity over time, a factor that was not evaluated in the initial validation study of the index.
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 | 0,000 | 0,003 |
| 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 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 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 ».