Temporal trends in radiologic tests performed at diagnosis in a cohort of children with inflammatory bowel disease (1983-2011)
Bibliographic record
Abstract
Children with inflammatory bowel disease (IBD) undergo radiologic tests at diagnosis to determine disease extent, behaviour, and complications. Over the past three decades, novel radiologic modalities have been introduced including computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US). The objective of this study was to characterize the trends in radiologic investigations used within six months of diagnosis in children with inflammatory bowel disease. We retrospectively identified all children ≤ 17 years old diagnosed with IBD between 1983 and 2011 and followed at the Alberta Children's Hospital, the sole tertiary care pediatric center in southern Alberta. We recorded radiologic investigations performed within six months of diagnosis (barium enema, small bowel follow through [SBFT], CT, MRI, US). Temporal trends were evaluated using joinpoint regression analysis. Subjects were categorized into 5-year intervals by year of diagnosis. Between January 1983 and June 2011, 565 children were diagnosed with IBD (300 Crohn's disease, 219 ulcerative colitis, and 46 IBD-unclassified or indeterminate colitis). During 1983-1987, 33 (89%) and 26 (70%) subjects received a barium enema and SBFT, respectively. During 1988-1992, 25 (63%) and 33 (83%) subjects received a barium enema and SBFT, respectively. During 1993-1997, 29 (31%) and 79 (84%) subjects received a barium enema and SBFT, respectively. During 1998-2002, 12 (11%) and 91 (83%) subjects received a barium enema and SBFT, respectively. During 2003-2007, 9 (5%), 124 (74%), and 1 (1%) subjects received a barium enema, SBFT, and CT/MRI, respectively. During 2008-2011, 1 (1%), 78 (67%), 20 (17%), 19 (16%), and 70 (60%) subjects received a barium enema, SBFT, CT, MRI, and US, respectively. At diagnosis, no subjects received an US before 2008 and no subjects received a CT or MRI before 2003. During 1983-2011, the use of barium enema and SBFT within six months of diagnosis decreased significantly (annual percent change -11% and -0.4%, respectively). During 2008-2011, the use of CT decreased significantly (annual percent change - 14%) and the use of MRI increased significantly (annual percent change +32%). During 2008-2011, subjects with Crohn's disease were more likely to receive CT, MRI, or US at diagnosis than subjects without Crohn's disease (odds ratio 4.5, 95% CI 1.8-12.2). As the types of radiologic modalities used in IBD have increased over the past three decades with the introduction of MRI, US, and CT, the use of modalities involving radiation (barium enema, SBFT, and CT) has decreased, affirming the goal to minimize radiation exposure in children. Enhanced understanding of the unique roles of each modality will allow further reduction of radiation exposure and improved abilities to determine disease extent, behaviour, and complications at diagnosis.
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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 | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".