28: Monitoring Pediatric Inflammatory Bowel Disease – A Retrospective Analysis of Transabdominal Ultrasound
Bibliographic record
Abstract
Poorly controlled inflammatory bowel disease (IBD) in children can lead to long- term complications in adulthood. There is a need for an imaging modality to effectively monitor IBD in the pediatric population. The current gold standard, ileocolonoscopy, requires anesthesia in children. Computed tomography (CT) is associated with a risk of radiation and is not recommended for repeated use. Magnetic resonance imaging (MRI) has proven to be effective, but may have limited availability. Transabdominal ultrasound is accessible, safe and well-tolerated in children; however, data to support its effectiveness in monitoring pediatric IBD is limited. The purpose of our study was to evaluate the accuracy and reliability of ultrasound (US) in the detection and monitoring of inflammation in pediatric IBD. 57 children were retrospectively included from an established database of children with IBD, and cross-referenced with Picture Archiving and Communication (PACs) database. Patients that had endoscopy and sonography within 60 days were included for comparison. Ultrasound parameters included: bowel wall thickness, mesenteric fat, hyperemia and lymphadenopathy. The weighted kappa statistic was calculated to assess agreement between sonographic and endoscopic findings. Using ordinal logistic regression and proportional odds models, a grey-scale ultrasound (US) score was created to using parameters that best predict disease activity, compared to gold standard endoscopy. There was moderate agreement in disease severity between sonographic and endoscopic findings (weight kappa=0.55). Significant clinical predictors of pediatric IBD disease severity were bowel wall thickness and hyperemia (P<0.05). According to this novel scoring system, 66% of patients were classified correctly, disease severity was under-estimated in 14% of patients and over-estimated in 17% of patients. The AUC was 90% for normal versus active disease. Additional analysis will be conducted with 76 patients from the same database. The parameters bowel wall thickness and hyperemia best predict disease severity in children with IBD. These parameters can be combined into an accurate predictive score, effective in the detection of inflammatory activity in children with inflammatory bowel disease.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| 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".