A219 A RETROSPECTIVE ANALYSIS COMPARING THE OUTCOMES OF INFLAMMATORY BOWEL DISEASE PATIENTS WHO ARE POSITIVE FOR C DIFFICILE TOXIN BY EIA VERSUS C DIFFICILE PCR
Bibliographic record
Abstract
Clostridium difficile infection (CDI) is defined by the presence of diarrhea with either positive C. difficile toxin test or pseudomembranes at colonoscopy. The diagnosis of CDI in Inflammatory Bowel Disease (IBD) is challenging due to diarrhea from underlying disease, lack of pseudomembranes and higher C. difficile carriage rates. Molecular testing (toxin gene PCR) has been shown to lead to over-diagnosis of CDI in one study that demonstrated worse clinical outcomes in patients who are C. difficile toxin positive versus PCR positive. In this study, we analyze data from IBD patients to determine if worse clinical outcomes of C. Difficile are in those who test positive by toxin (EIA) or PCR. We preformed a retrospective chart analysis of IBD patients who tested positive for C. difficile by either toxin or PCR. Data collection included baseline characteristics (demographics, IBD type and location, antibiotic exposure) and CDI and IBD outcomes (colectomy, hospitalization, death or need for escalation of IBD therapy). 3119 C. difficile tests were completed in IBD patients at University of Alberta IBD clinic from 2014–2017. 129 patients tested positive for C. difficile with 49% (63/129) by toxin EIA and 51% (66/129) by PCR. No differences were identified in outcomes when comparing toxin positive to PCR positive patients with similar rates of IBD/C. difficile-related hospitalizations, surgery or death found. There were also no differences found in IBD-related outcomes of need for escalation of therapy or flare-ups. In contrast to non-IBD patients, we found no difference in clinical outcomes for IBD patients who are C. difficile toxin (by EIA) or PCR positive. C. difficile PCR positivity may not represent innocent colonization in IBD patients. UAH Foundation
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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 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 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".