P-119 Transition Experience from Pediatric to Adult IBD Care
Bibliographic record
Abstract
Inflammatory bowel disease (IBD) has a peak incidence in the third decade of life but approximately 25% is diagnosed in childhood and adolescence. Pediatric patients must transition from family-oriented pediatric care to more independent adult care. A structured transition program may improve compliance and disease control. However, there is no consensus as to the best model for such transitions in IBD. We conducted a prospective survey of 33 pediatric patients transitioning to adult IBD care at McMaster Children’s Hospital in order to better understand their experiences and how their transition can be improved. We used validated instruments to assess transition readiness, satisfaction with medical care, self-perceived physical and mental health status, and health-related quality of life at transition. Nineteen (57.6%) pediatric IBD patients were included, of which 17 (89.5%) had Crohn’s disease and 2 (10.5%) had ulcerative colitis. The mean age at transition was 17 ± 0.5 years. The median disease duration was 3 years (range 2–14). Responses to the Inflammatory Bowel Disease Questionnaire (IBDQ) showed that quality of life at transition was excellent for 3 (15.8%), good for 14 (73.7%), and regular for 2 (10.5%). Compared to normative data from Canadian youth, SF36 scores from our subjects demonstrated decreased physical and social functioning, general health, emotional health and well-being, with increased pain and fatigue. Responses to the Transition Readiness Assessment Questionnaire (TRAQ) showed that only 3 (15.8%) were very confident about their skills for chronic condition self-management and only 5 (26.3%) felt very confident about their skills for self-advocacy and healthcare utilization. There was no correlation between disease duration and confidence in either of these skills. Mean domain scores from the Patient Satisfaction Questionnaire (PSQ) were 3.32 (SD 1.65) for general satisfaction, 2.99 (SD 1.83) for technical quality, 3.21 (SD 2.02) for interpersonal manner, 2.79 (SD 1.79) for communication, 2.71 (SD 1.78) for financial aspects, 2.97 (SD 1.76) for time with the doctor, and 3.01 (SD 1.83) for accessibility. There is a clear need for effective transition strategies that help pediatric patients move successfully to adult care. Although several strategies have been proposed to bridge these gaps, they have not been formally evaluated. These data assess the outcome of pediatric to adult transition under our current standard of care. The McMaster University/Hamilton Health Sciences IBD Clinic is introducing a formal transition program with access to a dedicated IBD nurse practitioner. Our outcomes will be reassessed once this program has been established.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".