Accuracy of biopsies for Helicobacter pylori in the presence of intestinal metaplasia of the stomach
Bibliographic record
Abstract
BACKGROUND/AIMS: Gastric cancer is the second leading cause of cancer-related death worldwide. The majority of gastric cancers is "intestinal-type" adenocarcinoma, caused in part by H. pylori infection. Chronic gastritis leading to atrophy and intestinal metaplasia (IM) can result in cancer. Studies have demonstrated reversibility of mucosal atrophy following H. pylori eradication. Concern has been raised regarding the sensitivity of gastric biopsy for H. pylori detection in the context of IM. MATERIALS AND METHODS: All cases of IM on gastric biopsy from a single gastroenterologist's outpatient practice were retrospectively reviewed from February 1, 2006 until May 31, 2012. RESULTS: In total, 105 IM cases were found, of which 37 (35.2%, 95% CI: 26.3-45.2) were H. pylori-positive on biopsy. Charts of the remaining 68 patients were reviewed for availability of other tests, namely urea breath test (UBT) and serology. Of 43 H. pylori-negative patients who underwent a UBT, 10 were positive for the infection (23.3%, 95% CI: 12.3-39.0). Amongst patients with coexisting autoimmune gastritis (AIG), 4 out of 9 (44.4%, 95% CI: 15.3-77.3) also had evidence of H. pylori infection by UBT, despite negative histology. CONCLUSION: For cases of gastric IM with negative histology for H. pylori, UBT should be considered, even in cases of AIG, as this may alter the management and clinical course for patients.
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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 | 0.002 | 0.016 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".