A155 QUALITY OF CARE IN THE INFLAMMATORY BOWEL DISEASES (IBD) CENTER FROM A TERTIARY REFERRAL HOSPITAL: PATIENT ASSESSMENT STRATEGY AT REFERRAL
Bibliographic record
Abstract
IBD impacts substantially on patient’s physical health, social functioning and quality of life. We aimed to analyze quality of care indicators (QIs) including structural and process QIs at referral in the McGill University Health Center (MUHC) IBD Center that includes 6 IBD specialists, 2 IBD nurses, 2 research nurses, and 2 IBD fellows with rapid access to colorectal surgeons and imaging. We retrospectively analyzed out- and inpatient records of all consecutive patient at the MUHC IBD clinic between June and December 2016. Demographic variables, outpatient visits, inpatient stays, laboratory, imaging and endoscopy data, medications history, and vaccination profile were captured. 653 patients (46.2% men, 66.6% Crohn’s disease (CD), age at referral: 41.3 years) were included. At referral 38% of CD patients had L3 classification, 46% complicated behaviors (B2 or B3) and 22% perianal disease.31% and 40% of UC patients had extensive and moderate-to severe disease, respectively. 60% of patients had a documented previous ileocolonoscopy at referral, 10% MRI and 28% CT. 16% of patients were on biologics. 66% had an ER visit, 45% required hospitalization, while 30% of CD patients had IBD-related surgery in the past. 78% of patients were employed. Patients were objectively re-evaluated at referral: 81% underwent ileocolonoscopy, 13% upper GI endoscopy, 31% of CD patients had abdomino-pelvic MRI or CT and 15% abdominal US. CBC, CRP and FCAL were measured in 85%, 75% and 24%, respectively. Medical therapy was changed in 55% (active disease: 78%, remission: 22%) with a maximum therapeutic step of biologics in 32%. 10% of patients required hospitalization while 5% surgery at referral. Our data support that a tight monitoring was applied at the MUHC IBD center including a high emphasis on objective patient (re)evaluation, and accelerated treatment strategy already at referral. NoneMcGill University Healtch Center (MUHC) Department of Medicine CAS Research Grant
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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 | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".