A182 HEPATOCELLULAR CARCINOMA (HCC) SCREENING PRACTICES IN CHRONIC HEPATITIS B (HBV) AMONG CANADIAN GASTROENTEROLOGISTS AND HEPATOLOGISTS: AN ONLINE SURVEY
Bibliographic record
Abstract
Current guidelines recommend HCC surveillance in certain chronic HBV carriers: Asian male age > 40, Asian female age > 50, African/Non-African blacks, family history of HCC and cirrhosis. To determine the HCC screening practices among Canadian gastroenterologists and hepatologists. An online survey was performed. At this point, 22 responded (5 hepatologists, 17 gastroenterologists) and their years in practice were: < 5 (18.2%), 6–10 (22.7%), 11–15 (13.6%), 16–20 (4.5%), and > 21 (40.9%). The number of HBV patients seen per year was: < 10 (31.8%), 10–100 (36.4%), 100–200 (18.2%), 200–500 (4.5%), and > 500 (9.1%). All hepatologists and 12 (70.6%) gastroenterologists treat HBV. 77.3% (17/22) order US about every 6 months at the time of clinic visits, while 13.6% (3/22) have an automatic recall system and 9.1% (2/22) refer back to primary care physicians. 54.5% (12/22) include alpha-fetoprotein (AFP) with ultrasound. For non-Asian, non-African HBV patients, 36.4% (8/22) screen them the same way as in Asians, 31.8% (7/22) screen with US every 6 months starting at an older age, 13.6% (3/22) screen with annual US at the same age, 9.1% (2/22) screen with annual US at an older age, and 9.1% (2/22) screen only cirrhotic. For young (age < 40) non-African HBV patients with a family history of HCC, 36.4% (8/22) screen with US every 6 months regardless of age, 27.3% (6/22) screen with US and AFP every 6 months regardless of age, 18.2% (4/22) screen with annual US regardless of age, and 18.2% (4/22) screen the same way as those without a family history. For HBV patients with non-alcoholic fatty liver disease (NAFLD): 50% (11/22) screen the same way as those without NAFLD, 31.8% (7/22) start screening with US every 6 months regardless of age if advanced liver fibrosis (≥F3) is present, 9.1% (2/22) screen with MRI every 6 months regardless of age if advanced fibrosis (≥F3) is present, and 9.1% (2/22) screen with US every 6 months regardless of age and stage of fibrosis. Obstacles to HCC screening reported: lack of an automatic recall system (54.5%; 12), patient non-compliance (31.8%; 7), and limited access to US/MRI (13.6%; 3). HCC screening practice vary widely among gastroenterologists and hepatologists for HBV patients with non-Asian, non-African descent, family history of HCC, and NAFLD. Incidence of HCC in these populations is unknown and HCC screening guidelines are desperately needed for these patients. Implementation of an automatic recall system could potentially facilitate HCC screening. None
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".