Food allergy and PPI-responsive esophageal eosinophilia
Bibliographic record
Abstract
This article was originally published online on 8 April 2015 A retrospective study to compare the food allergy prevalence in proton-pump inhibitor-responsive esophageal eosinophilia (PPI-REE) patients and patients with eosinophilic esophagitis (EoE) not responsive to PPI therapy. A chart review was performed for 30 patients diagnosed with EoE, prescribed PPI therapy and tested with atopic patch tests for a panel of food allergens. Patients were categorized as having PPI-REE if past clinical assessments noted significant symptomatic improvement with PPI therapy. Those without clinical response to PPI were categorized as non-responders. The two groups were compared on frequencies of other treatments offered (swallowed steroids (e.g. fluticasone, budesonide), esophageal dilatation), histology (eosinophil counts in esophageal biopsy at diagnosis) and frequency of positive food allergy tests. Statistical analysis used chi-square tests for frequency comparisons and student’s t-test for average eosinophil count comparison. Of the 30 patients reviewed, 12 were found to have PPI-REE. There was no significant difference in other treatments offered to PPI-REE and non-responsive patients (10/12 and 8/18, respectively; p = 0.21), average eosinophil counts at diagnosis (65.7 ± 29.2 and 42.6 ± 15.6, respectively; p = 0.14), nor in likelihood of food allergy as detected by skin prick (9/12 and 9/18, respectively; p = 0.98) or food patch testing (9/12 and 9/18, respectively; p = 0.60). It was hypothesized that PPI-REE cases would be less atopic, with regards to foods, than non-responders due to the possible prevalence of undiagnosed GERD in the former group [1.Liacouras CA Furuta GT Hirano I Atkins D Attwood SE Bonis PA Burks AW Chehade M Collins MH Dellon ES et al.Eosinophilic esophagitis: updated consensus recommendations for children and adults.The Journal of allergy and clinical immunology. 2011; 128 (e26, quiz 21-22.): 3-20Abstract Full Text Full Text PDF PubMed Scopus (1578) Google Scholar]. However, this review failed to show any statistically significant differences between the two groups. This is consistent with attempts of other groups to distinguish PPI-REE and EoE patients on other clinical parameters [2.Dellon ES Speck O Woodward K Gebhart JH Madanick RD Levinson S Fritchie KJ Woosley JT Shaheen NJ Clinical and endoscopic characteristics do not reliably differentiate PPI-responsive esophageal eosinophilia and eosinophilic esophagitis in patients undergoing upper endoscopy: a prospective cohort study.The American journal of gastroenterology. 2013; 108: 1854-1860Crossref PubMed Scopus (192) Google Scholar].
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".