The Incidence of Inflammatory Bowel Disease in 7 Ethnically Diverse Urban Populations in England: Results From the U.K. INception CohorT Epidemiological Study (UNITE)
Bibliographic record
Abstract
Introduction: Previous studies have shown the incidence of UC in South Asians (SA) is higher than the Caucasian population. These studies were done over 20 years ago. The current epidemiology of IBD in the multiethnic UK is unknown. Methods: To describe the UK incidence of IBD and distribution within ethnic groups. Census data (2011) was used for background population size, ethnic groups and to identify areas with high SA populations where Indian and Pakistani were the predominant groups. The incidence was calculated by using the number of subjects in each ethnic group in the background population as the denominator. Adult patients (>16 years) with newly diagnosed IBD (fulfilling Copenhagen diagnostic criteria) were prospective recruited over one year in 7 catchment areas with high SA population. Data including demographics ethnic codes and disease phenotype (Montreal classification) was collected onto the validated Epicom database. Results: Over 1 year IBD was diagnosed in 351 cases; 219 ulcerative colitis (UC), 107 Crohn's disease (CD) and 26 Inflammatory bowel disease unclassified. (IBDU) (Table 1). Overall incidence of UC was higher than CD (9.69/100,000 vs 4.80/100,000), for all populations except Pennine (3.31/100,000 for CD and 2.76/100,000 UC). Crude IBD incidence rates varied between populations: lowest was 6.81/100,000 in Pennine, North Manchester and highest 26.11/100,000 in Leicester. The majority of ethnic groups were Caucasian, Indian or Pakistani (298/351). IBD, UC and CD incidence was similar between Pakistani and Caucasian groups. CD incidence was similar across all ethnic groups. UC incidence was significantly higher in the Indian population compared to Caucasians and Pakistanis (p < 0.001). There was no significant difference in disease extent of UC between ethnic groupsTable: Table. Incidence rates per 100 000 for inflammatory bowel disease, Crohn's disease, ulcerative colitis and inflammatory bowel disease unclassified in England for patients aged 16 years or older in 2016/17Conclusion: This is the first prospective study to report the incidence of IBD in seven ethnically diverse UK populations with the highest IBD incidence in Leicester. We observed wide variation in IBD incidence between regions within the same country, differences in UC incidence within the SA population (Indian vs Pakistani origin) and similar CD incidence rates across all groups. The Indian population seems particularly susceptible to UC suggesting an inherent predisposition beyond environmental factors. Finding an explanation for this observation will be critical to a better understanding to what triggers the disease.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".