A40 INCIDENCE, CLINICAL FEATURES, AND INVESTIGATION OF ACHALASIA IN NEWFOUNDLAND AND LABRADOR
Bibliographic record
Abstract
Achalasia is a rare esophageal motility disorder of unknown etiology. Patients commonly present with dysphagia, regurgitation and weight loss. Previous epidemiologic studies have suggested an equal male to female ratio and adult onset. Incidence rates range between 0.29 – 1.63/ 100,000 per year. Endoscopic and esophagram findings are often abnormal, however, manometry is required to diagnose achalasia. This 11-year retrospective study outlines incidence, clinical features, and describes diagnostic findings in incident cases of achalasia in Newfoundland and Labrador. Patient charts with ICD codes indicating a diagnosis of achalasia between 2005 and 2015 were retrieved from medical records. Charts with a diagnosis of achalasia by manometry prior to 2005 were not reviewed. Patients diagnosed with achalasia based on endoscopy or imaging prior to 2005 were included if their initial diagnostic manometry occurred between 2005 and 2015. The date of diagnosis was recorded as the date of official diagnostic manometry. Epidemiologic data, manometry, endoscopy and esophagram findings were compiled by chart review. 73 cases of achalasia were diagnosed with manometry between 2005 and 2015 in Newfoundland and Labrador. The average age at diagnosis was 52. Males represented 60% of cases. The midpoint incidence of achalasia was 1.42/100,000. Dysphagia occurred in 97% of patients, regurgitation in 73%, weight loss in 71%, chest pain in 22%, and aspiration in 11%. Upper endoscopy was abnormal in 81% of patients. The most common endoscopic finding was narrowing of the gastroesophageal junction followed by dilatation of the esophageal body. Abnormal barium esophagram occurred in 74.0%. An abnormal GEJ was the most common finding on barium esophagram, seen in 64%, followed by esophageal dilatation in 41%. Abnormal manometry was a key feature in all patients. The incidence of achalasia in Newfoundland is similar to the incidence reported by a similar study in Alberta, although higher than reported by studies in Singapore and Iceland. Age and sex distribution is similar to findings in previous studies. Upper endoscopy and barium esophagram were frequently, but not exclusively, abnormal. There were several limitations to the present study, including suspected cases that were treated without referral for manometry, and lack of access to endoscopy and esophagram records. 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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".