P127 An assessment of a pancolonic adaptation of the ulcerative colitis endoscopic index of severity in comparison to clinical and biochemical markers of disease activity in paediatric ulcerative colitis
Bibliographic record
Abstract
Background: The ulcerative colitis Endoscopic Index of Severity (UCEIS) is an endoscopic index of disease activity, applied to the most severely affected region of the rectosigmoid, developed for use in adult ulcerative colitis (UC) patients. Given that most paediatric UC cases involve extensive colitis, we hypothesized that a pancolonic adaptation of the UCEIS may be more appropriate for children. We aimed to compare such an adapted version and the traditional UCEIS to clinical and biological markers of disease activity in this population. Methods: In this single-centre prospective study, Paediatric UC Activity Index (PUCAI), physician global assessment (PGA), fecal calprotectin (FC) and C-reactive protein (CRP) were measured in consecutive paediatric UC patients undergoing colonoscopy. Colonoscopies were scored by 2 blinded IBD physicians using the traditional rectosigmoid UCEIS and a pancolonic adaptation derived by summing individual UCEIS scores applied to the rectum, left colon, transverse colon and right colon, and dividing by the number of visualized segments. Spearman correlations were calculated between variables. The ability of both UCEIS versions to discriminate between disease activity, reflected by PUCAI, was assessed graphically. Results: 35 UC patients were enrolled (53% male, median age 12.7 years, 72% pancolitis). Median PUCAI score, FC and CRP were 15 (range 0–75), 1435 (range 29–16782) μg/g and 1.4 (range 0.1–17.1) mg/L, respectively. Spearman correlations are shown in Table 1. Both versions of the UCEIS demonstrated similar correlations with PGA, PUCAI, FC and CRP. Both scores were most highly correlated with PUCAI, and moderately correlated with PGA and FC. Correlations were lower with CRP. The boxplot in Figure 1 illustrates the distribution of the rectosigmoid and pancolonic UCEIS per disease activity category defined by established PUCAI cut-offs. Based on this, the rectosigmoid UCEIS appears to discriminate disease activity better than the colonic UCEIS. Table 1. Spearman correlations between traditional and pancolonic UCEIS and clinical and biochemical markers of UC activity Figure 1. Box plots illustrating the distribution of the rectosigmoid and pancolonic UCEIS per disease activity category based on PUCAI. Conclusions: The traditional UCEIS applied to the rectosigmoid region and an adapted pancolonic version performed similarly in this paediatric UC cohort when compared to various symptom-based and biological markers of disease activity. This likely relates to the usually homogeneous pattern of disease in paediatric UC in the rectum and more proximally in the colon.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".