A112 THE VALIDITY OF PATIENT-LED SELF-SCREENS FOR IDENTIFYING MALNUTRITION IN INFLAMMATORY BOWEL DISEASE
Bibliographic record
Abstract
Malnutrition is common in Inflammatory Bowel Disease (IBD) and is associated with significant morbidity and mortality. Identification of high-risk patients using an efficient, and sensitive screen is the first step to dietitian referral for nutritional assessment and intervention. To determine the validity of patient led self-screens against a dietitian-led subjective global assessment (SGA) to detect malnutrition in IBD patients. Adult patients were prospectively recruited from IBD clinics in Edmonton and Calgary. Patients completed 4 self-screening questionnaires: abridged Patient-generated Subjective Global Assessment (abPG-SGA), Malnutrition Universal Screening Tool (MUST), Canadian Nutrition Screening Tool (CNST) and Malnutrition Screening Tool (MST). A dietitian blinded to the results of the screens carried out a gold standard nutritional assessment using the SGA. A total of 95 IBD patients (60 Crohn’s (CD) and 35 Ulcerative colitis (UC)), 52% male were assessed. According to Harvey-Bradshaw Index and partial Mayo scores, 14% of CD and 28% of UC patients had moderate to severe disease. The most common symptoms affecting dietary intake in this patient population were diarrhea (33%), pain (32%), poor appetite (24%) and fatigue (22%). According to the dietitian –led SGA, 21% of patients (15% Crohn’s, 31% UC) were moderately to severely malnourished. Patients classified themselves at moderate to high risk of malnutrition in 50% of cases (abPG-SGA), 37% (MUST), 15% (CNST), 21% (MST). Of the 4 screening tools, the abPG-SGA had the best test characteristics (see Table 1). The abPG-SGA is a promising nutrition screening tool in patients with IBD. It is time-efficient and can be completed by patients in the waiting room. With the high sensitivity and high negative predictive value for malnutrition detection, all patients who screened at risk of malnutrition would be appropriately referred for further assessment. This tool has been successfully utilized in other chronic disease populations. Future clinical practice should integrate the abPG-SGA into routine IBD nutrition screening. Measures of validity of the abPG-SGA, MUST, CNST and MST against the dietitian-administered SGA in IBD abPG-SGA abridged patient generated subjective global assessment, MUST malnutrition universal screening tool, CNST Canadian nutrition screening tool, MST malnutrition screening tool, SGA subjective global assessment, PPV positive predictive value, NPV negative predictive value 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 | 0.013 | 0.043 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".