P296 Persistent symptoms, CRP elevation and treatment changes over time in Crohn's disease patients are associated with bowel damage progression as expressed by deterioration of Lemann Index score
Bibliographic record
Abstract
Background: Crohn's disease (CD) is a chronic and progressive disease causing bowel damage (BD) which will lead to complications and surgery. Recently, the Lemann Index (LI) has been developed to measure the cumulative structural BD at a given time independent of disease activity. In this retrospective study, we investigated factors potentially related to structural BD progression in CD as expressed by changes in LI score over time. Methods: We studied a cohort of 63 patients with 2 serial abdominal cross-sectional imaging studies (CT and/or MRI) at least 24 months apart, over a period of 5 years of follow-up at a tertiary IBD centre. Imaging and endoscopic data were used to compute LI using a Microsoft Access-based calculator. Changes in LI between the 2 time-points were calculated (delta LI, DLI = LI2-LI1) and patients were classified into 2 groups: those with zero or negative DLI values (stable or improved, iDLI) and those with positive DLI values (deteriorated, dDLI). The percentages of interval time (IT) with symptomatic disease luminal and/or perianal, increased CRP and exposure to various treatments were estimated. Non-parametric statistical analyses for independent and paired groups were performed to identify factors related to BD progression. Results: In the entire CD cohort, median LI2 score increased significantly (median LI2, 8.5 versus median LI1, 7.5; p=0.021) over a median period of 30 months. LI increased (dDLI) in 32 patients (51%) and remained stable or decreased (iDLI) in 31 patients (49%). There were no significant differences in baseline characteristics between the 2 groups except for more common prior exposure to 2 biologics and more frequent active disease in dDLI group (Table 1). Factors independently associated with a significant increase in median LI2 were: persistent symptomatic disease during >50% IT (DLI=1.62, z=2.685, p=0.007), persistent CRP elevation >50% IT (DLI=1.31, z=2.103, p=0.035), frequent or continuous steroid use (DLI=2.2, z=3.309, p=0.001) and significant changes in treatment (DLI=2.2, z=2.418, p=0.016) during the interval period (Wilcoxon signed-rank test, Figure 1). Figure 1. Lemann Index in Crohn's disease patients at 2 time points. Conclusions: Our results show that ongoing Crohn's disease activity as indicated by persistent symptomatic disease, persistent CRP elevation, frequent steroid use and changes in treatment is associated with progressive bowel damage.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".