A17 LINEAR GROWTH IMPAIRMENT IN CANADIAN CHILDREN PRESENTING WITH NEW ONSET IBD: A MULTI-CENTRE INCEPTION COHORT STUDY
Bibliographic record
Abstract
An important target in the management of pediatric inflammatory bowel disease (IBD) is normal linear growth and pubertal development. Greater awareness of IBD and more effective therapies are anticipated to reduce the prevalence of linear growth impairment as a complication of chronic intestinal inflammation. To evaluate the current magnitude of linear growth impairment at diagnosis in pediatric Crohn’s disease (CD) and ulcerative colitis (UC). Since April 2014, the Canadian Children IBD Network (CIDsCANN) inception cohort study prospectively enrolled patients aged </= 17 years, presenting to 12 academic centers across Canada. Recommended assessment of linear growth at presentation includes height measurement, pubertal staging, ascertainment of pre-illness heights and mid-parental height (MPH) calculation. All growth parameters are standardized utilizing the Centers for Disease Control (CDC) 2000 reference tables. ‘Deficit height z-score’ was calculated using the formula: ‘Predicted Height z-score’ minus ‘Actual Height z-score’. Among the initial 800 participants (58% male; CD: 59%, UC: 30%, IBD-unclassified: 11%), median age at presentation was similar for the three disease sub-categories (12.9 yrs; IQR 10.8–15.0), but duration of symptoms prior to diagnosis was significantly longer in CD (5 months, IQR 3–12 months) vs. UC (3 months, IQR 1–6 months) (p<0.001). Macroscopic disease location based on Paris classification for UC was: 70% E4; 12% E3; 16 % E2 and for CD was: 58% L3; 23% L2; 18% L1. Linear growth impairment, based on historical growth parameters, occurred in 21% of CD patients (8% as the main presenting feature), and 3% of UC patients (but none as the main presenting feature). Predicted height z-scores (based on MPH) were normally distributed (mean 0.07, SD 0.8) with no difference noted between CD and UC patients. As shown in Table, the UC cohort had normal height at diagnosis, but in the CD cohort height was reduced compared to both the healthy population and predicted values. This was especially especially prominant among younger vs. older CD patients (p=0.05), despite similar symptom duration (median 5 months) prior to diagnosis (Table). Males demonstrated a greater deficit than females. Linear growth impairment still occurs prior to the recognition of Crohn’s disease in young patients, but its magnitude is less than in previous eras. Deficit in Height Z-score based on the Mid-Parental Height calculation appears a useful metric in quantifying linear growth impairment. CH.I.L.D 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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".