P444 Active perianal Crohn’s disease negatively impacts patients’ quality of life, psychosocial wellbeing and is associated with barriers related to social determinants of health
Notice bibliographique
Résumé
Abstract Background Perianal fistulizing Crohn’s Disease (PFCD) is associated with poor quality of life (QoL) and increased healthcare utilization. However, the effect of PFCD on patients’ lives remain incompletely understood. We conducted a survey-based study of patients with PFCD to examine the impact of perianal fistula disease activity on QOL, psychosocial wellbeing, and barriers related to SDOH. Methods Patients aged 18 years and above with a diagnosis of PFCD were included between July and November 2023 at Mount Sinai Hospital. Patient data, including demographics and clinical data, were obtained from patients and chart review. Perianal disease classifications were assessed through chart review. Crohn’s anal fistula quality of life (CAFQOL) scale, PROMIS scale for anxiety and depression, Internalised stigma for mental illness (ISMI), Everyday discrimination scale, health first screening tool for SDOH and the Cantril ladder of life scale were administered to patients. Patients with active PFCD, defined as perianal pain and/or drainage, were compared to patients with inactive PFCD, defined as lack of perianal pain or drainage. Descriptive statistical analysis was performed using SPSS Results A total of 50 patients were included in the study, of whom 39 had active disease and 11 inactive disease (Table 1). Annual household income was lower among patients with active PFCD (p=0.017). Disease characteristics such as Montreal classification, HBI and perianal disease classification, presence of proctitis, surgical history were similar across both groups. Overall, patients with active PFCD compared to inactive PFCD had higher CAFQOL scores (mean active:inactive;1.82:0.44, p<0.001). Patients with active PFCD also had higher rates of depression and anxiety (mean 2.06:1.23, p=0.020). Internalised stigma was higher among patients with active PFCD. There was no difference in discrimination faced as a consequence of PFCD. 20.5% and 12.8% patients with active PFCD reported facing social isolation and food insecurity respectively. By the Cantril ladder, patients with active PFCD had lower current life satisfaction compared to inactive PFCD (mean 6.03:7.60, p=0.024). However, there was no difference in their outlook on life satisfaction in 5 years. Conclusion In our cohort, perianal disease activity alone results in significantly worse quality of life and negatively impacts psychosocial wellbeing. Patients with active PFCD are at risk for barriers related to SDOH which are known to have implications on health equity.
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 | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 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 ».