S3409 Assessment of Toronto Criteria for Response to Ursodiol Use Among PBC Patients in a Community Outpatient Setting
Notice bibliographique
Résumé
Introduction: Primary biliary cholangitis (PBC) is a chronic autoimmune disorder characterized by portal inflammation and intrahepatic biliary duct destruction. Ursodiol is the first-line treatment for many patients with PBC. Response to ursodiol has been measured by either Toronto criteria, Barcelona criteria, or Paris I criteria, with Toronto criteria being the most commonly used criterion in the United States. Previous studies have assessed the Toronto criteria in tertiary care facilities and might have missed many patient follow-ups. The primary aim of this study is to re-assess the effectiveness of Toronto criteria for measuring the response to ursodiol in a community outpatient clinic with regular patient follow-ups. Methods: A retrospective cohort study was conducted at Liver Associates of Texas Hepatology outpatient clinics in Houston, Texas. All patients diagnosed with PBC from January 2018-May 2021 were included. Lab results before and 1 year after starting ursodiol in these patients were collected from their records. Response to Ursodiol was measured using the Toronto criteria [alkaline phosphatase (ALP)≤1.67 times upper limit of normal (ULN) are responders and ALP >1.67 times ULN are non-responders]. Continuous variables were compared with either the Student’s T-test or Wilcoxon Rank-sum test. Chi-square test, Fisher’s exact test and logistic regression were used for categorical variables. Significance level was set at 5%. Results: Data for ursodiol response was available for 111/136 patients with PBC included in the study. 65/111 (58.6%) were ursodiol responders and 46/111 (41.4%) were ursodiol non-responders. Non-responders were significantly younger than responders. 36.8% were white, 14.7% were Hispanic, 12.5% were African American, 3.7% were Asian, 2.2% were Native American, and 30.2% were of unspecified race. Majority of the patients were female with no significant difference in gender distribution. Creatinine levels (mg/dL) were significantly different after ursodiol use [median: 0.75 vs 0.78, P=0.023] ALP levels significantly improved after ursodiol use [P=0.001]. Conclusion: ALP levels were significantly decreased among ursodiol responders vs non-responders confirming the use of Toronto criteria. In addition, non-responders were significantly younger than responders. Further studies are required to assess causal factors associated with increase in creatinine after ursodiol use.Table 1.: Alkaline Phosphatase and age in Ursodiol responders vs non-responders among PBC (Primary Biliary Cholangitis) patients.
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 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 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 ».