A55 ASSESSMENT OF THE APPROPRIATE USE OF GASTROINTESTINAL ENDOSCOPY AT A TERTIARY CARE CENTRE
Bibliographic record
Abstract
Knowledge of appropriate indications for colonoscopy is essential for quality endoscopic practice and ideal future management of patients. The American Society for Gastrointestinal Endoscopy (ASGE) published guidelines for the appropriate use of endoscopy to help hospitals, endoscopy units, and endoscopists achieve safe and responsible endoscopic practice. These guidelines outline indication statements that specify the circumstances in which colonoscopy is indicated. The primary objective of this study is to determine whether the endoscopic procedures performed at St. Paul’s Hospital are appropriate according to ASGE guidelines. A total of 400 consecutive charts (161 male and 239 females; mean age 57.9 +/- 14.3 years) were retrospectively reviewed to assess the appropriateness of colonoscopy performed by gastroenterologists at St. Paul’s Hospital. Appropriateness was determined by comparing the procedure indication to the ASGE guidelines. Fisher’s exact test was used to assess detection of significant lesions. A p-value of < 0.05 was considered significant. 98% underwent colonoscopy for an appropriate indication, while it was only considered inappropriate for 2% of patients. Detection of significant lesions (colon cancer and adenomatous polyps) was higher in appropriate colonoscopies compared to inappropriate (39.5% vs. 0.0%, p=0.025). The most frequent indications for colonoscopy were bleeding (40.8%), screening/surveillance for colonic neoplasia (35.6%), and IBD affecting the colon where more precise diagnosis or determination of the extent/activity of the disease would influence management (6.3%). The vast majority of colonoscopy procedures being done at St. Paul’s Hospital are for appropriate indications (98.0%). The greater yield of significant lesions from appropriate procedures suggests the effectiveness of the ASGE guidelines, however, additional steps should be taken to make the guidelines more specific and to standardize them across sites with a wide variety of patient populations to ensure uniformity in care. 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 | 0.003 | 0.024 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".