P0485 Seroproteomic index of endoscopic activity associates with endoscopic outcomes in a longitudinal cohort of adults ulcerative colitis
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Notice bibliographique
Résumé
Abstract Background A seroproteomic index of endoscopic activity (serum index) is validated in adult CD but its performance in Ulcerative Colitis (UC) is lacking. We prospectively evaluated the serum index in an observational cohort of adult UC undergoing longitudinal endoscopic assessments. Methods UC underwent Montreal classification, were consented and followed longitudinally for their outcomes (clinical and endoscopic) at a single center. Serum specimens were collected at the time of assessments. The UC endoscopic index score (UCEIS) was calculated, with scores above 4 points indicating endoscopic active disease. Clinical symptoms were measured using the partial Mayo score with score < 2 points indicating clinical remission. The serum index which is a composite of CRP-HS plus 12 other proteins in an algorithm that associates with endoscopic outcomes in CD was applied unmodified in UC. The index ranges from 0 to 100 points where higher index are associated with higher likelihood of endoscopic active disease. All sera were processed by an accredited clinical laboratory. Receiver operating characteristic curves (ROC with area under the curve [AUC]) and logistic regression were employed to evaluate the index in distinguishing endoscopic outcomes. Nonlinear mixed effect models were used to correlate the longitudinal changes in UCEIS (>1 endoscopic assessment). Results A total of 231 patients with UC (mean age 41 years, n=115 females) were enrolled, and 294 serum samples with an UCEIS score were collected. Average partial Mayo score was 2.5±2.7 points [SD] with 50% assessments in clinical remission. Average UCEIS was 2.2±2.3 points (22% [n=66] with UCEIS>4 points). Average CRP, and serum index was 5.2±8.1 mg/L, and 38±19 points, respectively. Comparison in distinguishing UCEIS>4 points yielded significantly higher AUC with serum index (AUC=0.797±0.034) than with CRP (AUC=0.714±0.035) (p=0.047). In subjects with more than one endoscopic assessment (n=49/112 endoscopies), the change in partial Mayo scores, CRP and serum index associated with the changes in the UCEIS (Table). At optimal cutoff, serum index above 42 points yielded 73% sensitivity and 78% specificity in identifying moderate to severe endoscopic disease (OR= 9.0 95%CI: 5.0-17.2) (p<0.001) (PPV=52%, NPV=89% with 25% pretest probability). In multivariate analysis, endoscopic active disease associated with the absence of clinical remission (aOR=0.05 (95%CI: 0.01,0.16) with each point increase in serum index yielding 1.05 (95%CI: 1.03,1.07) fold higher likelihood of endoscopic active disease (Figure). Conclusion We have validated the performance of a seroproteomic index of endoscopic activity in adults with UC demonstrating its potential as a non-invasive biomarker.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 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) | 0,000 | 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 découle