A128 CROHN’S DISEASE DIAGNOSIS AFTER PROCTOCOLECTOMY AND ILEAL POUCH-ANAL ANASTOMOSIS FOR ULCERATIVE COLITIS: PREDICTIVE FACTORS
Bibliographic record
Abstract
Total proctocolectomy and ileal pouch anal-anastomosis (IPAA) is considered a curative procedure for ulcerative colitis (UC). However, symptoms of Crohn’s disease (CD) can occur postoperatively in some cases. Having previously reviewed the postoperative prevalence of CD, our aim was to identify potential predictive factors present at time of surgery. We reviewed the files of 302 patients with an IPAA performed between 1985 and 2014 at the CHUM Hôpital Saint Luc in Montreal. 163 patients with a minimal follow-up of 5 years postoperatively were included in the analysis. The preoperative diagnosis was UC in 145 cases and indeterminate colitis (IC) in 18 cases. There were no cases of CD. New onset CD was diagnosed post-operatively in 35 cases. When comparing IPAA patients with or without CD, the following predictive factors for CD were identified: active tobacco smoking at time of surgery (5 % UC vs 22 % CD p=0.006), preoperative steroid treatment (86 vs 100% p=0.014), interrogation from the clinician regarding a putative CD (7 vs 26 % p=0.004), mouth ulcers (12 vs 27% p=0.093). A past history of tobacco smoking was associated with UC (38 % UC vs 19 % CD p=0.058). No difference between endoscopic or histological appearance was noted between both groups. Pouchitis was observed more frequently in the CD group (63 vs 26 % p<0.001) In our study, endoscopic and clinical characteristics at time of surgery failed to differentiate apparent UC patients later identified as CD. Some clinical points such as smoking history statistically correlated with a postoperative diagnosis of CD. In practice, clear predictive factors of clinical outcome remain to be determined. 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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".