National differences in Ulcerative Colitis experience and management: An international survey of patients and healthcare professionals
Bibliographic record
Abstract
An international survey was conducted to assess differences between countries in patients' and healthcare professionals' (HCPs) perceptions regarding ulcerative colitis (UC) and its management. Structured, cross-sectional, Web-based questionnaires assessing multiple disease indices were administered to adult chronic UC patients as well as experienced physicians and nurse specialists actively managing UC patients in Canada, France, Germany, Ireland, Spain, and the United Kingdom. Participants were recruited directly through hospitals and clinics, physician referrals, and patient and HCP access panels; patient advocacy groups/associations were not used for recruitment. A total of 775 patients, 475 physicians, and 50 nurses completed the survey. Patients' self-reported UC severity varied considerably from country to country (mild, 16%-45%; moderate, 46%-58%; severe, 4%-36%). Patients in Ireland reported the highest percentage of severe UC (36%), while patients in Spain reported the lowest percentage (4%). While physician ratings of UC severity among their own caseloads were more consistent across surveyed countries, doctors in Spain also provided the lowest estimate of severe UC cases (9%). Mean number of patient self-reported flares over the past year was greatest in France (8.0) and lowest in Ireland (2.5); 69% or more of patients considered this number of UC flares to be normal in all countries except Spain, where 71% considered the reported number to be abnormal. Expectations of UC control also differed, with a low of 26% of patients in Ireland stating that remission realistically involved ‘living without symptoms” compared with a high of 65% in Spain. Across all countries, a higher proportion of patients (45%-69%) compared with physicians (29%-45%) considered UC symptoms to affect patients' quality of life; this patient-physician difference was most apparent in France (69% vs 34%). Self-reported compliance with 5-aminosalicylic acid (5-ASA) therapy was highest for patients from Spain (91%) compared with patients from any other surveyed country (50%-73%). The highest percentage of patients reporting satisfaction with 5-ASA therapy was in Canada (99%), while the lowest was in Spain (58%). Canadians were the most likely to report arranging regular HCP visits (49%), and were the most willing to be open about discussing their UC during these consultations (79%); by contrast, Irish patients were least likely to arrange HCP visits (14%), and reported the lowest percentage willing to openly discuss their UC (46%). In conclusion, Spanish patients appeared to have the most optimistic perceptions of UC, highest expectations of UC control, and best compliance rates, consistent with Spanish physician reports of few severe UC cases; Canadian patients reported the highest rate of satisfaction with 5-ASA therapy and arranging regular HCP visits. However, a lower percentage of physicians considered that UC symptoms affected quality of life for the patient.
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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 | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".