P0712 RE-EVALUATION OF THE PEDIATRIC CROHN???S DISEASE ACTIVITY INDEX: USEFULNESS IN THE PRACTICE SETTING
Bibliographic record
Abstract
Introduction: The Pediatric Crohn’s Disease Activity Index (PCDAI)was developed to measure differences in disease activity following therapeutic interventions (JPGN, 1991).Its reported use has largely been limited to research settings. We sought to evaluate its efficacy in reflecting physician global assessment (PGA) during routine clinical practice, to re-evaluate specific scoring ranges as indicators of disease activity, and to examine its ability to reflect short-term changes in patient condition following therapy. Methods: A prospective observational registry of children with newly diagnosed IBD was established at 18 US/Canadian pediatric gastroenterology centers in January 2002. Patient evaluation and management was at the discretion of each physician and not dictated by standard protocol. The database was queried regarding PGA and PCDAI on Crohn’s disease patients at baseline and then at 30 days to 15 months later. Only patients for whom all PCDAI fields were completed were eligible for evaluation. Results: 142 patients had concomitant PGA/PCDAI at baseline. 33 patients had PGA mild (mean ± SD PCDAI 18.9 ± 9.7), 78 PGA moderate (31.0 ± 13.1) and 31 PGA severe (46.0 ± 16.4) (p<0.001 for all comparisons). Receiver-operator curve (ROC) analysis suggested a cut score of 30 or higher best represented moderate/severe disease at baseline (sensitivity 0.64, specificity 0.91) and a PCDAI<10 best represented inactive disease at follow-up(sensitivity 0.81, specificity 0.73). Analysis of short term PCDAI changes over time (baseline to 30 day or 3 month)showed a mean decrease in PCDAI of 24 ± 10 points when PGA changed from severe or moderate to mild or inactive (n=58); 90% of these patients showed a 15 point or greater PCDAI decrease. Conclusion: The PCDAI works well to assess disease activity in a practice setting even without formal operator instruction. Cut scores for inactive and moderate/severe disease are similar to those previously reported. Change in PCDAI reflects short term changes in PGA enabling the PCDAI to adequately reflect improvement in patient condition following therapeutic intervention. The PCDAI remains a valuable tool for CD clinical trials.
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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 | 0.007 | 0.039 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".