S948 Relationship Between Hospitalization, Surgery and Achievement of Clinical Remission or Clinical Response in Moderate to Severe Crohn’s Disease Patients: Results From the UNITI/IM-UNITI Trials
Notice bibliographique
Résumé
Introduction: Crohn’s disease (CD) is a chronic disease with high burden for patients and payers. Treatment aims include induction and maintenance of clinical remission (CRem). Understanding the relationship between rates of hospitalization and surgery and health states can help determine the economic burden. This analysis used results from the UNITI/IM-UNITI trials (CNTO1275CRD3001-3) of patients with moderate to severe CD, to determine the relationship between hospitalization and surgery rates and each health state over 1 year. Methods: Hospitalization and surgery data from UNITI/IM-UNITI were pooled across arms and across induction and maintenance phases. Based on CRem and response achieved at each visit (weeks 0-52), patients’ exposure time were classified into three health states (HS) using the Crohn's Disease Activity Index score: CRem, clinical response without clinical remission (CResp) and active CD. Hospitalization and surgery events were assigned based on the HS at the visit prior to the event. The base case (BC) analysis included CD-related hospitalizations and surgeries only, a first sensitivity analysis was performed including both CD- and non-CD-related hospitalizations and surgeries, and a second sensitivity analysis was performed on patients randomized to maintenance only. Annualized rates were estimated by HS adjusting for the exposure time in each health state. Results: The analysis included a total of 773 patients in CRem, 723 in CResp and 1,255 in active CD. BC results showed significantly fewer hospitalizations per 100 patient-years (PY) in CRem (6.50), and numerically fewer per 100 PY in CResp (14.37) compared to active CD (20.82). Similarly, patients in CRem had significantly fewer surgeries per 100 PY vs active CD (4.18 vs 15.57), and the difference was not statistically significant vs patients in CResp, who incurred 11.35 surgeries/100 PY. P-values are reported in Figure. CRem (9.11 days) and CResp (9.86 days) also had a numerically shorter mean duration of hospitalization compared to active CD (15.77 days). These results were consistent with those from both sensitivity analyses. Conclusion: Annualized hospitalization and surgery rates from the UNITI/IM-UNITI trials were significantly lower for patients in CRem and lower but non-significantly for patients in CResp, compared to patients in active CD. CRem and CResp had a numerically shorter mean duration of hospitalization compared to active CD.Figure 1.: Annualized CD-related hospitalization and surgery rates in UNITI/IM-UNITI in each health state
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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 | 0,028 | 0,038 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,010 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 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 ».