P411 Benefits of implementing a rapid access clinic in a high-volume inflammatory bowel disease centre: Accessibility, resource utilisation and outcomes
Bibliographic record
Abstract
IBD impacts on patient’s physical health, social functioning and quality of life, contributing to the health-economic burden associated with the disease, especially in emergency situations. We aimed to prospectively measure indicators of quality-of-care, after implementation of a new rapid access clinic (RAC) at a tertiary care IBD centre. Consecutive patients from the McGill University Health Centre who accessed the RAC via email were prospectively included, between June and September 2017. Time to medical appointment, utilisation of imaging, endoscopy, laboratory, treatment decisions and need for unplanned emergency room (ER) visits or admissions 30–90 days after consulting the RAC was assessed. Seventy-four patients (35% men, mean age: 35 years, CD: 72%, L3: 59%, B2–3: 39%, UCE3: 48%, biological therapy: 76%, previous surgery: 23%) were included. Seventy-five per cent of requests were considered appropriate for an RAC appointment. Outpatient visits were a median 2 days (mean 3.3) after the email request. Five patients required an ER visit within 30 days after the RAC appointment, out of which 3 were initiated during the rapid appointment. Two of three patients required admission and underwent urgent IBD-related surgery. No patients required an ER visit within 90 days. Treatment was modified in 40 patients (72%). Laboratory assessment including FCAL (65%) and therapeutic drug monitoring (30%) was performed as appropriate. The need for subsequent accelerated assessment was infrequent. Fast-track endoscopy was performed in four patients, and two patients had an abdominal/pelvic CT for assessment. Implementation of an RAC improved healthcare delivery by avoiding unnecessary ER visits and patient care by increasing access to an IBD centre.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".