P269 Utility of capsule endoscopy in the diagnosis of inflammatory bowel disease and its disease extent
Bibliographic record
Abstract
Capsule endoscopy is an established non-invasive tool for the evaluation of small bowel due to its ability to visualise subtle mucosal abnormality that may not be detected by cross-sectional imaging. We aim to evaluate its utility in patients with suspected inflammatory bowel disease (IBD) and in known IBD patients in a single tertiary hospital. Retrospective analysis was done for all patients who underwent capsule endoscopy with PillCam™ SB video capsule system from the National University Hospital, Singapore from January 2006 to December 2016. Clinical data, laboratory results, and medications were assessed using electronic medical records and electronic prescription. Statistical analysis was done using SPSS. Categorical variables were compared using χ2 test with Fisher exact test and continuous variables were compared using Student’s t-test where appropriate. There were 426 patients who underwent capsule endoscopy from January 2006 to December 2016. Among these, 35 (8.2%) patients underwent capsule endoscopy for suspected IBD while 16 (3.8%) patients underwent capsule endoscopy for known IBD. There were 19 (37.3%) patients in the paediatric age group and 32 (62.7%) patients in the adult age group. Thirty-one (60.7%) patients were males and 20 (39.2%) patients were females. Of the 35 patients with suspected IBD, 7 (20.0%) patients were diagnosed with IBD after capsule endoscopy was done. Suspected IBD patients who were subsequently diagnosed with IBD following capsule endoscopy had a significantly lower mean albumin level (39 ± 4.41 g/l) compared with patients who were not diagnosed with IBD (39.0 ± 4.41 g/l vs. 43.0 ± 3.28 g/l; p = 0.039), and were more likely to have hematochezia (3/7; 42.9% vs. 2/28; 7.1%, p = 0.044). There were no significant difference in haemoglobin, white cell count, C-reactive protein, creatinine, presence of diarrhoea, and weight loss, between patients who were subsequently diagnosed with IBD and those who were not. Among the 16 patients with known IBD, there was a change in IBD phenotype following capsule endoscopy in 2 (12.5%) patients, with extension of involvement from Montreal L2 (colonic) to L3 (ileocolonic) . Four (25.0%) patients had intensification of treatment following capsule endoscopy: one patient was started on biologics and 3 others were started on immunomodulators. Although IBD-related evaluation compromised a small proportion of overall capsule endoscopy referrals, capsule endoscopy is a useful tool in making the diagnosis of IBD, and in the evaluation of the extent of IBD, resulting in optimisation of treatment.
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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 | 0.002 | 0.001 |
| 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) | 0.003 | 0.001 |
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".