A158 THE WAITING GAME: A SYSTEMATIC REVIEW OF ACCESS TO INFLAMMATORY BOWEL DISEASE CARE AND ITS IMPACT ON PATIENT OUTCOMES IN CANADA AND NOVA SCOTIA
Bibliographic record
Abstract
BACKGROUND: Inflammatory Bowel Disease (IBD), including Crohn’s Disease (CD) and Ulcerative Colitis (UC), is a chronic early onset disease with debilitating lifelong effects on patients’ physical and mental health. IBD is also associated with significant financial and social ramifications. Canada is reported as having the highest prevalence rate of IBD in the world. Within Canada, the province of Nova Scotia (NS) has the highest incidence rates of IBD. Appropriate access to timely and quality care is essential for disease management but very little is known about the impact of access to IBD care on disease related outcomes. AIMS: How does access to IBD care inform patient outcomes in Canada, and more specifically, in Nova Scotia? METHODS: A systematic review of literature pertaining to access to IBD care in Canada was conducted in July 2016. Summon and NovaNet databases were used in conjunction with an internet search engine being used to find relevant gray literature. The search terms “Access” + “Care” + “IBD” + “Canada” + “Nova Scotia” were used. Results were refined for “full texts online” and limited to peer reviewed journals published in English between 2006 and 2016. Search results were sorted by relevance. Exclusion criteria were articles not focused on both IBD and Nova Scotia. A secondary search was conducted using Novanet using the search terms “IBD” + “Nova Scotia.” RESULTS: After the initial search, Summon produced 19 results, while Novanet could not find any matching results. After screening, only 2 results were included in the synthesis (Figure 1). The secondary search yielded 2 articles; however, after screening, none of the articles were included. Included articles and relevant grey literature were analyzed using the patient-centered Five ‘A’s of Access framework (approachability, acceptability, availability & accommodation, affordability and appropriateness) created by Levesque, Harris and Russell (2013). CONCLUSIONS: Despite an increasing focus on access to health care and patient-centered evidence based medicine, and a notably high incidence rate of IBD in Nova Scotia, this systematic review uncovered large gaps in literature concerning access to IBD care in Canada and Nova Scotia. While some innovative work is being done in the province to address issues of access, the lack of available research in the field of IBD means that actual and perceived access is not adequately understood. Increased patient-centered research in the field of IBD would benefit the availability of accessible patient-centered care through evidence-based systems planning. FUNDING AGENCIES: 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 | 0.011 | 0.063 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.005 |
| Bibliometrics | 0.015 | 0.027 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".