A277 CHARACTERISTICS OF PEDIATRIC IBD AT DIAGNOSIS ASSOCIATED WITH SUBSEQUENT USE OF BIOLOGIC THERAPY: A RETROSPECTIVE STUDY
Bibliographic record
Abstract
Inflammatory bowel disease (IBD) is a heterogeneous group of idiopathic conditions commonly treated with increasingly potent anti-inflammatory and immunomodulator medications. The most efficacious medications currently available are biologic agents (TNF-α antagonists). Limited evidence exists to guide the decision to start biologic therapy. Identification of risk factors at presentation that are associated with the eventual use of biologics could be useful for facilitating earlier treatment decisions. To identify the clinical, biochemical, and radiographic characteristics of IBD at diagnosis associated with subsequent use of biologic therapy. Charts of all IBD patients actively followed at our centre were reviewed. Data pertaining to clinical, biochemical, and radiologic characteristics at diagnosis were extracted. Disease activity was described using the Pediatric Crohn’s Disease Activity Index (PCDAI) and the Pediatric Ulcerative Colitis Activity Index (PUCAI). Therapeutic course was also reviewed, including the timing of immunomodulator and/or biologic therapy initiation. Analyses were performed using SPSS version 21. 218 patients with IBD were identified, 124 (57%) with Crohn’s disease, 61 (28%) with ulcerative colitis and 33 (15%) with IBD-type unclassified. 122 (56%) patients received biologic treatment. Time to biologic use was negatively associated with disease activity index at diagnosis for both Crohn’s disease (R2=0.06, P=0.024) and ulcerative colitis (R2=0.33, P<0.002). For all patient groups, binary logistic regression demonstrated that lower height percentile, decreased albumin, and increased CRP at diagnosis (Nagelkerke R2=0.29) were associated with biologic use. Receiving biologics within nine months of diagnosis was associated by multivariate logistic regression with lower height percentile, decreased albumin and increased age at time of diagnosis. (Nagelkerke R2=0.22). In our cohort, we identified patient characteristics at the time of IBD diagnosis, which were associated with early use of biologic therapy. Further prospective evaluation will help to determine if initiation of biologics based on patient characteristics at the time of IBD diagnosis leads to improved outcomes. Regional Medical Associates Scholarship
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".