A149 ENDOSCOPIC BALLOON DILATION IS A SAFE AND EFFECTIVE THERAPEUTIC INTERVENTION FOR PATIENTS WITH SMALL BOWEL CROHN’S DISEASE
Bibliographic record
Abstract
Crohn’s disease (CD) is an inflammatory bowel disease that is characterized by chronic transmural inflammation of the gastrointestinal (GI) tract which can become complicated by the formation of strictures. CD can affect any part of the GI tract with 30–40% of patients having isolated small bowel CD. Complicated CD carries with it significant risk factors for the patient that can often only be alleviated through surgery or medication. However, the advent of Endoscopic Balloon Dilation (EBD) has allowed for temporary relief of obstructive symptoms and could potentially be an alternative therapy that prolongs the need for surgical intervention. This study is conducted to assess the safety and efficacy of EBD in patients with small bowel CD. A retrospective chart review was undertaken to examine all patients with small bowel CD who underwent BAE between July 2013 and August 2017. The data collection included patient demographics, disease characteristics, procedural characteristics, and stricture dilation data. 152 BAEs (84 DBE, 68 SBE) were performed on 82 patients (45 female). The mean age at the time of the BAE was 53.4 ± 15.7 years. The mean disease duration was 17.4 ± 14.0 years. Fifty (61.0%) patients had undergone a previous gastrointestinal surgery. Of the 152 procedures, 84 (55.3%) required EBD, constituting 58.5% (48) of the total patients. In total, 191 strictures were dilated; 75.9% (145) were native strictures, 24.1% (46) were anastomotic strictures. There were a total of 3 (2.0%) complications, and there were no perforations or deaths. Thirty-five procedures (23.1%) involved a non-traversable stricture; in 25 (71.4%) of these procedures, the non-traversable stricture prevented the endoscopist from EBD. Endoscopic Balloon Dilation is a safe and effective intervention for the treatment of small bowel Crohn’s disease and is likely under-utilized as an endoscopic tool. EBD can alleviate obstructive symptoms for both patients who have had previous resections or those with primary stenosis. In some patients, EBD may be effective enough to prolong or prevent the need for surgical resection. Procedural data for patients with small bowel Crohn’s disease undergoing Endoscopic Balloon Dilation CEGIIR (The Center of Excellence for Gastrointestinal Inflammation and Immunity Research)
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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 | 0.001 |
| 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 | 0.000 |
| 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".