P172 Postoperative recurrence of Crohn's disease: correlation between endoscopy and bowel ultrasound
Bibliographic record
Abstract
Postoperative Crohn’s disease recurrence (POR) is currently assessed by ileocolonoscopy. B-mode bowel sonography (US) is an alternative, non-invasive, non-ionising and well tolerated diagnostic method. Our aim was to validate US, and to establish a correlation between the different ultrasound parameters of activity and Rutgeerts endoscopic score We selected 31 patients with Crohn’s disease in follow-up at our unit, who had underwent surgical ileocolic resection, which performed ileocolonoscopy and US for the diagnosis of POR, with a difference between both tests lesser than 6 months. Recurrence was assessed by ileocolonoscopy using the Rutgeerts score, considering: i0–i1 absence of recurrence; ≥i2 endoscopic recurrence. The echographic findings were bowel wall thickness (BWT), hyperaemia, layer pattern, involvement of the mesenteric fat, presence of adenopathy and transmural complications (fistulas and abscesess). Clinical characteristics of the study population are reported in Table 1. Main demographic, clinical characteristics according to Montreal classification. Ileoconoloscopy detected recurrence in 20 of 31 patients (64%). A statistically significant association was identified between wall thickness and recurrence (i ≥ 2) (mean 2.5 mm non recurrence vs. 5.2 mm recurrence, p = 0.002). A relationship was observed between Rutgeerts endoscopic score and BWT: 2.5 mm (SD 0.39) for i0–i1; 3.68 mm (SD 0.33) for i2 and 6.79 mm (SD 0.29) for i3–i4. However, this relationship did not reach statistical significance (p = 0.57). To establish the relationship between each of the ultrasound variables with the endoscopic recurrence, a multi-variate analysis was performed using logistic regression. It was identified that a BWT< 3 mm is associated with the possibility of endoscopic recurrence with a relative risk reduction (RRR) of 2.03, the preservation of the layer pattern RRR = 1.05, the absence of involvement of mesenteric fat RRR = 38.15 and the absence of adenopathies RRR = 1.23 (p = 0.003). ROC curve analysis (image 2) shows a BWT of 2.8 mm as the best cut-off point (SE: 95% ES: 82% AUC: 90%) to discriminate patients without recurrence (i < 2). For BWT > 3 mm, the classic parameter, shows SE: 90% ES: 82% AUC: 87% ROC curve analysis There is a good relationship between the different echographic parameters of activity (bowel thickness, hyperaemia, wall distortion, etc.) and the presence of endoscopic recurrence, as well as the severity of the recurrence.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".