Frequency and treatment of disease flares among individuals with Crohn's disease
Bibliographic record
Abstract
According to the American College of Gastroenterology guidelines, corticosteroids are effective in inducing remission, but not in maintaining it, among individuals with moderate-to-severe Crohn's disease (CD). However, more than 50% of individuals treated with corticosteroids acutely become steroid dependent or steroid resistant. This study will report the 1) frequency of, 2) severity of, 3) treatment of, and 4) maintenance therapy following disease flares among individuals with CD. The National Health and Wellness Survey, a nationally representative internet-based survey, was administered during the 4th quarter of 2009 to individuals aged ≥ 18 years. This analysis reports results for the cohort of respondents with a self-reported physician diagnosis of CD. T-tests were performed to assess differences between groups. 778 individuals with CD completed the survey (63% female; average age = 46.2 years), and of these, 13%, 18%, and 10% of respondents reported > 1 flares/ week, > 1 flares/month, and one flare/month, respectively. Flares lasted 6.2 days on average with the majority classified as moderate in severity (52%). Among respondents experiencing > 1 flares/week, a significantly (P<0.05) higher percent classified their disease as moderate (21%) or severe (29%) rather than mild (4%) and many used steroids (22%), biologics (16%), or immunomodulators (15%) as maintenance therapy (P =NS). Among respondents experiencing > 1 flare/month, a significantly (P<0.05) higher percent classified their disease as moderate (25%) or severe (26%) rather than mild (12%) and many used biologics (26%), immunomodulators (18%), steroids (15%), or 5-aminosalicylates (5-ASAs) (15%) as maintenance therapy (P <0.05 for biologic vs. 5-ASA). Disease flares were most often treated by adding a steroid to the current treatment regimen (33%), increasing the dose of the current medication (22%), or adding an antibiotic (19%). A significantly (P<0.05) higher percent of individuals with severe disease reported adding a steroid (54%) or an antibiotic (42%) compared to those with moderate (40%, 21%, respectively) and mild (24%, 14%, respectively) disease.
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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 | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".