P-121 Transition Experience from Inpatient to Ambulatory IBD Care
Bibliographic record
Abstract
Management of inflammatory bowel disease (IBD) is inherently multidisciplinary and often fragmented. Despite advances in therapy, many patients will require hospital admission and 50% will require at least one surgery to manage their disease. The transition from inpatient to outpatient care is a vulnerable time for patients. Healthcare transition periods are associated with poorer health outcomes, and a structured transition program may improve compliance and disease control. We conducted a prospective survey of 67 adults with IBD transitioning from inpatient to ambulatory care in order to better understand their experiences and how their transition can be improved. We used validated instruments to assess satisfaction with transition and medical care, self-perceived physical and mental health status, as well as health-related quality of life at transition. Twenty-six subjects (38.8%) provided adequate data for analysis, of whom 18 (69.2%) had Crohn’s disease and 8 (30.8%) had ulcerative colitis. The mean age at transition was 43 ± 17 years. The median disease duration was 10 years (range 0.25–30). Nine hospitalizations (34.6%) were medical and 17 (65.4%) were surgical, with median lengths of stay 5.5 (range 1–15) and 8.5 (range 5–62) days, respectively. Responses to the Inflammatory Bowel Disease Questionnaire (IBDQ) showed that quality of life at transition was good for 10 subjects (38.5%), regular for 12 (46.2%), and bad for 4 (15.4%). Compared to normative Canadian data, SF36 scores from our subjects demonstrated decreased physical and social functioning, general health, emotional health and well-being with increased pain and fatigue. Using the Care Transitions Measure 15 (CTM-15), 16 subjects (61.5%) reported the quality of their care transition to be good and 5 (19.2%) reported it to be excellent. Mean domain scores from the Patient Satisfaction Questionnaire (PSQ) were 2.88 (SD 1.77) for general satisfaction, 3.01 (SD 1.60) for technical quality, 3.42 (SD 1.72) for interpersonal manner, 2.44 (SD 1.87) for communication, 2.73 (SD 1.55) for financial aspects, 2.50 (SD 1.75) for time with the doctor, and 2.81 (SD 1.72) for accessibility. There is a clear need for transition strategies that help adults with IBD manage their disease after discharge from the hospital and during their transition back to ambulatory care. Strategies to bridge this gap have not been formally evaluated. These data assess the outcome of inpatient to ambulatory care transition under our current standard of care. The McMaster University/Hamilton Health Sciences IBD Clinic is exploring a formal transition program led by a dedicated IBD nurse practitioner. Our outcomes will be reassessed following introduction of this pilot program.
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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 | 0.004 |
| 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 | 0.002 |
| 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".