P727 Change in Crohn's disease behavior in a prospective European population-based inception cohort – the ECCO-EpiCom cohort
Bibliographic record
Abstract
Background: Crohn's disease (CD) is a progressive disease that over time can lead to the development of complications such as strictures or internal penetrating disease that will ultimately lead to surgery. Only few population-based studies from the biological era and widespread use of immunodulators have investigated the change in disease behaviour and subsequent risk of surgery in CD. Methods: The EpiCom-cohort is a population-based cohort of unselected patients with inflammatory bowel disease diagnosed in 2010 in Eastern and Western European centres. Patients were followed prospectively for five years and clinical data were captured throughout the follow-up period and entered in a validated web-based database. Disease behaviour as defined according the Montreal classification as B1: non-stricturing, non-penetrating, B2: stricturing; B3: penetrating based on endoscopy, cross-sectional imaging or surgery. The risk of changing behaviour from B1 to B2 or B3 as well as the risk of surgical resection was analysed by Cox regression analyses using the proportional hazard assumption including multiple covariates (age, gender, disease location, diagnostic delay, smoking status, change in behaviour, geographic region, and early treatment with biologics). Results: The EpiCom-cohort is a population-based cohort of unselected patients with inflammatory bowel disease diagnosed in 2010 in Eastern and Western European centres. Patients were followed prospectively for five years and clinical data were captured throughout the follow-up period and entered in a validated web-based database. Disease behaviour as defined according the Montreal classification as B1: non-stricturing, non-penetrating, B2: stricturing; B3: penetrating based on endoscopy, cross-sectional imaging or surgery. The risk of changing behaviour from B1 to B2 or B3 as well as the risk of surgical resection was analysed by Cox regression analyses using the proportional hazard assumption including multiple covariates (age, gender, disease location, diagnostic delay, smoking status, change in behaviour, geographic region and treatment with biologics within 6 months from diagnosis). Table 1. Disease behaviour in Crohn's disease at diagnosis and follow-up Conclusions: In this European population-based inception cohort of unselected CD patients 14% of patients progressed to B2 or B3 after five years of follow-up. The risk of surgery was increased in patients with B1 who progressed to B2/B3. No clinical predictors for progression in behaviour including smoking and treatment with biological therapy could be identified.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".