Addressing Psychological Needs of Individuals with Inflammatory Bowel Disease Is Necessary
Bibliographic record
Abstract
We thank Drs. Hopkins and Moulton for their letter, which highlights a number of the limitations we report in our systematic review.1 We agree that the use of ICD-9 coding can be an insufficient proxy for a diagnosis of depression or anxiety. We included the studies because frequently these codes are identified by clinicians and thus would reasonably classify the individuals. However, this is not the case universally, and so their inclusion potentially contributed to less precise estimates. As identified in the review, we did not undertake a meta-analysis because of the inconsistency of the published data. At the point of registering our protocol, we had anticipated that the data we reviewed would most likely be unsuitable for a meta-analysis, but we would aim to complete one if appropriate. Our decision postdata extraction was not to pool the data using meta-analysis techniques because of the evident heterogeneity. In our opinion, pooling the data in this review would be misleading. However, because no other research group has attempted a relevant systematic review to date, our intention was to move the data synthesis one step closer to a future meta-analysis, and thus we presented mean percentages/weighted means where it was possible. It can be difficult to meaningfully interpret comparisons of anxiety/depression prevalence between inflammatory bowel disease and other chronic conditions, given the heterogeneity of the patient samples in the available studies. Certainly, there is limited generalizability, and summary findings should be interpreted with caution, as we aimed to do in our report. The information was reflecting the current state of research and in fact highlights the need for further appropriate and direct comparisons with other types of chronic diseases. We argue that the conclusions arising from a systematic evaluation of each study are supported by the cited research. Given the high prevalence of mental conditions in inflammatory bowel disease and their detrimental impact on disease course,2 we find it surprising that Drs. Hopkins and Moulton question the recommendation to screen and treat anxiety and depression in inflammatory bowel disease. This would not be best practice3,4 nor in the interest of patient biopsychosocial well-being. Although we agree better quality studies are needed, our recommendation would be to focus on comparative studies with carefully selected controls rather than recommending population-based studies, which are unlikely to be feasible because of associated costs.
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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 | 0.008 | 0.069 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.006 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.014 | 0.016 |
| Insufficient payload (model declined to judge) | 0.009 | 0.002 |
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".