Epidemiology of inflammatory bowel disease among an indigent multi-ethnic population in the United States
Bibliographic record
Abstract
BACKGROUND: Environmental factors, including socioeconomic status, may affect inflammatory bowel disease (IBD). There is a paucity of data on the epidemiology of IBD among patients of low socioeconomic status. AIM: To examine the epidemiologic features of IBD among African-American, Hispanic, and Caucasian patients from a county hospital, where the majority of the patients are socioeconomically disadvantaged. METHODS: A retrospective study was conducted on a cohort of patients diagnosed with IBD based on clinical, radiologic, endoscopic, and histological data. We reviewed charts of adults aged 20-70 years diagnosed with IBD between 2000 and 2006. Demographic data, disease subtype, and phenotypic features of IBD were recorded based on the Montreal Classification. The data were analyzed using the chi-square, Fisher exact, Wilcoxon rank-sum, and Student's t-tests. RESULTS: The study cohort included 273 patients, with 54% female, 30% Caucasian, 44% African-American, and 26% Hispanic. Over half (54%) of the patients had Crohn's disease (CD), and 46% had ulcerative colitis (UC). The mean age at diagnosis was 40 ± 14 years with no significant difference between CD and UC (age 43 ± 13 versus 44.5 ± 14, respectively; P = 0.5). Females were diagnosed at a significantly later age than males (46 ± 13 years versus 40 ± 13, respectively; P = 0.001). This trend remained significant for females with CD and UC, and across each racial/ethnic group. Hispanic patients were diagnosed with UC more often than Caucasian patients (64% versus 34%; odds ratio [OR] 3.5; 95% confidence interval [CI]: 1.8-6.5, P = 0.0003) or African-Americans (64% versus 43%; OR 2.3; 95% CI: 1.3-4.3, P = 0.005). Among the 147 patients with CD, 54% had fistulizing and/or stricturing disease. The prevalence of fistulizing, stricturing, and inflammatory CD was similar across all age, gender, and racial/ethnic groups. CONCLUSIONS: Within an indigent population, UC was diagnosed more often in Hispanics than CD. Females were diagnosed at a significantly older age than males across all racial/ethnic groups. There was no difference in the CD phenotypes between the three ethnic groups. Understanding the epidemiology of IBD will require examination of the interactions between gender, race/ethnicity, and environmental factors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".