DEVELOPMENT OF A PEDIATRIC ULCERATIVE COLITIS ACTIVITY INDEX (PUCAI)
Why this work is in the frame
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Bibliographic record
Abstract
Background: No index of ulcerative colitis (UC) activity has been rigorously formulated, and none was developed among children. We developed an evaluative multi-item measure of UC activity for use in multi-center pediatric trials. Methods: A judgmental approach was used for item generation using a Delphi group of 48 pediatric IBD experts and literature review. Further item reduction and weighting was performed by regression analysis on a prospective cohort of pediatric UC patients (n = 10 patients/df) at 4 IBD centers. Physician global assessment of disease activity (PGA) was used as the dependent variable and PUCAI items as the predictors. β estimates of the model served to guide the weighting, governed by maximizing R square and aided by a correlation matrix. Reliability was assessed by Intra-Class Correlation coefficient (ICC) using ANOVA. Validation (using 2 constructs: predicted strong correlation with PGA and fair with endoscopic activity) and responsiveness testing of the weighted PUCAI are underway on a separate prospective cohort. Results: A list of 41 potential items was generated by the expert panel. Mean ratings and rank order of ratings were considered in item reduction, following 4 rounds of feedback to the group. Gradations for the 11 highest ranking items were selected by consensus following much iteration. The draft PUCAI was completed independently by 2 physicians assessing 150 children with UC (mean age 12.7 ± 3.8 yr, 52% males; 77% extensive UC; 34% moderate to severe; 19% mild and 47% quiescent). Reliability was excellent (ICC > 0.9 for all items). 6 items were most important in the regression analysis: stool number, consistency and blood, albumin, abdominal pain and nocturnal diarrhea together explained 93% of variation in PGA. In preliminary validation (n = 25) the weighted index correlates well with PGA and colonoscopic appearance and is responsive to change. Conclusions: The PUCAI was developed following a rigorous multi-step process, has excellent interobserver reliability, and provides a measure of pediatric UC activity.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.000 | 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 it