P786 The use and escalation of treatments in patients with inflammatory bowel disease; a 10 years follow-up of a Danish population-based inception cohort
Bibliographic record
Abstract
The long-term treatment strategies and change between medications in Inflammatory bowel disease (IBD) in the age of biologics has not been well described. We aimed to characterise the treatment strategies in IBD in a well-defined population-based inception cohort of Crohn's disease (CD) and ulcerative colitis (UC) patients after 10 years of follow-up. All patients (n = 513) diagnosed with CD, UC or IBD unclassified between January 1, 2003 and December 31, 2004 in a well-defined area were included. Clinical data regarding treatment and outcome were recorded and patient records linked with four national registries to ensure complete data capture and follow-up. Treatments were grouped into four treatment levels (TL): (1) 5-aminosalicylates (5-ASA) ± topical steroids, (2) oral steroids ± 5-ASA or topical steroids, (3) immunosuppressant (azathioprine or 6-mercaptopurine ± steroids and/or 5-ASA), (4) biologics (infliximab or adalimumab in combination with any of the above). Disease classification was made according to the Montreal classification. In a linear regression model, gender, age class, diagnostic delay, smoking behaviour, disease behaviour, location, and extent at diagnosis was used as independent variables. A total of 213 CD and 300 UC patients were followed. TL over time is shown in Figure 1 and 2. Characteristics of patients’ TL are shown in Table 1. In CD, only younger age at diagnosis was associated with the risk of escalating to TL 3 or 4 (OR (CI 95); A2: 0.7 (0.5, 0.98); A3: 0.5 (0.4,0.8) [ref: A1]). In UC patients, former smoking (OR (CI95); 1.3 (1.0–1.6) [ref: never smoker]), and extent at diagnosis was significantly associated with the risk of escalating to TL 3 or 4 (OR (CI95); E2: 1.4 (1.2,1.8), p < 0.001; E3: 1.4 (1.1,1.7) [ref: E1]). After the first initial years after diagnosis, stability occurs regarding treatment levels of both CD and UC patients. Escalation to immunomodulators and biologics was more frequently necessary in CD, even after the initial years, compared with UC patients. Crohn’s disease patients’ treatment level throughout 10 years of follow-up ulcerative colitis patients’ treatment level throughout 10 years of follow-up Characteristics of Crohn’s disease and Ulcerative colitis patients’ treatment level after 10 years of follow-up
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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) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 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".