Diagnostic Criteria for Eosinophilic Esophagitis: A 5‐year Retrospective Review in a Pediatric Population
Bibliographic record
Abstract
BACKGROUND: The diagnostic criterion based on the number of eosinophils (Eos) per high-power field (HPF) does not appear to capture all patients with eosinophilic esophagitis (EE). OBJECTIVES: To determine whether EE has been underrecognized at our institution, clinical variables predicting EE, and whether the Luna eosinophil granule (LEG) stain detects eosinophils better than hematoxylin and eosin (HE). MATERIALS AND METHODS: Esophageal biopsies of 202 children younger than 18 years old from 2000 to 2004 were reviewed and Eos/HPF was recorded. Clinical variables from charts were reviewed and a marginal logit model was used to determine significance. LEG stains for 60 randomly selected patients were prepared and compared to HE originals. RESULTS: EE diagnoses have risen from none in 2000 to 23 in 2004. The clinically significant variables that predicted EE were improvement from EE treatment (160 times more likely to have EE; P < 0.0005), final endoscopic diagnosis of EE (31 times; P = 0.004), absence of vascular pattern on endoscopy (20 times; P = 0.008), and vertical furrows on endoscopy (29 times; P = 0.039). LEG stain appeared to be superior to HE in detecting low Eos/HPF (mean 24.82 and 38.53, respectively). Peak counts of eosinophils in the most involved HPF significantly correlated with highest average count of eosinophils per HPF in the most involved specimen (Pearson correlation 0.958). CONCLUSIONS: : Misdiagnosed EE cases decreased but prevalence appeared to increase. LEG potentially can be a more sensitive stain. The key variables that predict EE were typical endoscopic findings and improvement from specific EE treatment.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".