A151 WAIT TIMES FOR IBD SURGERY IN EDMONTON: 50% ARE WAITING TOO LONG
Bibliographic record
Abstract
Despite advancement in medical therapy, approximately three-quarters of patients with Crohn’s disease (CD) and one-third of ulcerative colitis (UC) patients will require surgery in their lifetime. In the absence of accepted standards for appropriate wait times for IBD surgery, we rely on expert opinion. In Alberta, the Adult Coding Access Targets for Surgery (ACATS) project has defined optimal waiting times (WT) surgery, including IBD-related surgery. Delayed surgery is believed to lead to poor outcomes and increased risk of postoperative complications. It is unknown whether IBD patients in Edmonton are receiving elective surgery (ES) within the defined WT. To determine the proportion of IBD patients who underwent elective surgery outside the provincially accepted wait times, overall and by type of surgery. This is a 5-year, retrospective, quality assurance study of adult patients in Edmonton who underwent elective IBD surgery (January 1, 2013 to Dec 31, 2017). Data was extracted from the Edmonton Elective OR Database using relevant procedure codes. Surgical wait time was defined as the time between the decision to perform surgery and the date of the procedure for each type of surgery. Descriptive statistics were calculated to determine the proportion of patients who had surgery outside the accepted WT; and how long after the accepted time they waited. Of note, patients who had emergency surgery were excluded from this analysis. Overall, 385 surgeries were included. Half (50.9%) occurred outside predefined WT. For surgeries outside the window, 141 (71.9%) were done 50% beyond predefined WT with 111 (56.6%) occurring more than 100% beyond. Table 1 shows the #surgeries done electively by type, the average wait time, and the proportion done outside the accepted wait time. The average wait time for elective IBD surgery in Edmonton is longer than the provincially accepted wait times. Half of patients undergoing elective IBD surgery are waiting too long. Table 1. Number of surgeries, average wait time and proportion waiting longer than the accepted by type of IBD surgery. Funding Agencies:
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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 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".