Systematic review and meta‐analysis: assessment of factors affecting disability in inflammatory bowel disease and the reliability of the inflammatory bowel disease disability index
Bibliographic record
Abstract
Summary Background The Inflammatory Bowel Disease Disability Index (IBD‐DI) has recently been developed for patients with Crohn's disease (CD) and ulcerative colitis (UC). Aim To assess the severity of disability and associated factors using the IBD‐DI, and review the validity of the IBD‐DI as a tool. Method Systematic review of cross‐sectional studies. Patients included had UC or CD and were classified as active, in remission, or needing surgery, biological and/or steroid treatment. We included studies assessing disability using the IBD‐DI and that were captured by electronic and manual searches (January 2017). The possibility of bias was evaluated with the Newcastle‐Ottawa Scale. Results Nine studies were included with 3167 patients. Comparatively, patients with active disease had higher disability rates than those in remission (SMD [CI95] = 1.49[1.11, 1.88], I2 = 94%, P<.01), while patients on biological treatment had lower disability rates than those receiving corticosteroid treatment (SMD [CI95] = −0.22[−0.36, −0.08], I2 = 0%, P<.01). Disease activity and unemployment were found to be associated factors. The IBD‐DI scored “good” for internal consistency, “fair” to “excellent” for intra‐rater reliability and “excellent” for inter‐rater reliability. Construct validity was “moderately strong” to “very strong” and structural validity was found to be mainly unidimensional. The IBD‐DI had excellent responsiveness, while its interpretability was only useful on a group level. Conclusions This systematic review and meta‐analysis found a significant association between disease activity, treatment received and disability; although significant heterogeneity was found. The IBD‐DI is reliable and valid, but further studies are needed to measure its interpretability.
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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 | 0.032 | 0.087 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.022 | 0.037 |
| Bibliometrics | 0.010 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 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".