P739 The progression of inflammatory bowel disease throughout Latin America: a systematic review
Bibliographic record
Abstract
The incidence and prevalence of ulcerative colitis (UC) and Crohn's disease (CD) is stabilising in the Western world, but increasing in developing countries. Epidemiological data on IBD is lacking from Latin American countries. The aim of this systematic review is to summarise the clinical and epidemiological information on IBD arising from countries in Latin America. Three databases (MEDLINE, EMBASE, SciELO) were searched until September 12, 2018 for clinical or epidemiological data on IBD from all Latin American countries and territories. We assessed the following outcomes: incidence and prevalence; ratio of patients diagnosed with UC vs. CD (ratios greater than 1 favour UC); phenotype as defined by the Montreal Classification; proportion of population prescribed IBD medications (i.e., steroids, 5-ASA, immunomodulators, and anti-TNF agents); and proportion of intestinal resections. Choropleth maps of the UC:CD ratio were created using Jenks Natural Breaks. We identified 1434 abstracts with 126 articles selected for full-text review, and 61 articles were used for data extraction. Incidence and prevalence of IBD is steadily rising throughout Latin America. For example, the incidence of CD in Brazil rose from 0.08 in 1988 to 0.68 (1991–1995) to 5.5 per 100000 in 2015. The highest reported prevalence of IBD is in Argentina (2007) at 15 and 82 per 100 000 for CD and UC, respectively. The UC:CD ratio exceeds 1 in all regions throughout Latin America with the exception of Brazil where the states of Alagoas, Rio de Janeiro, and Mato Grosso do Sul reported more CD than UC patients Figure 1. UC:CD ratio map. The proportion of patients prescribed anti-TNF has steadily risen for CD (e.g. Brazil: 29.6% in 2005–2012 to 43.4% in 2014), but not UC (e.g. Brazil: 4.5% in 2014). Surgery for IBD is overall declining. In contrast, other regions showed stable colectomy rates pre- and post-introduction of anti-TNF for UC: e.g. in Peru, colectomy for UC 6.9% in 2001–2003 and 6.2% in 2004–2014 Figure 2. Proportion of Crohn’s disease (CD) and ulcerative colitis (UC) patients prescribed anti-TNF therapy and undergoing an intestinal resection in Latin America. The burden of IBD is expanding throughout Latin America. Heterogeneity between countries may offer important clues into the pathogenesis of IBD, as well as identify regions requiring standardisation in management and healthcare delivery. Additional population-based epidemiologic studies are needed to better define the evolving burden of IBD throughout Latin America.
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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 | 0.004 | 0.016 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.005 |
| Bibliometrics | 0.011 | 0.014 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 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".