A260 HEALTH-RELATED QUALITY OF LIFE IMPACT OF STEROIDS VS. EXCLUSIVE ENTERAL NUTRITION FOR INDUCTION IN A LARGE CANADIAN PEDIATRIC IBD INCEPTION COHORT
Bibliographic record
Abstract
IMPACT is the only validated pediatric inflammatory bowel disease (IBD) disease-specific health-related quality of life (HRQOL) questionnaire. As one form of patient-reported outcome, HRQOL is an increasingly important measure of treatment effectiveness and adverse effects in pediatric patients with Crohn’s disease (CD). To assess whether type of induction therapy for CD had an effect on HRQOL as measured by IMPACT between three and nine months following initial treatment. Data was obtained from the Canadian Children IBD Network (CIDsCaNN) inception cohort study, which is a multi-centre, prospective study of children aged ≤17 years with IBD. Data was extracted for patients with CD who received steroids or exclusive enteral nutrition (EEN) as induction therapy. IMPACT is reported as both total and domain scores (well-being, social, emotional, and body image). A higher score on IMPACT indicates a better HRQOL. Differences were compared between groups using independent samples t-tests, Mann-Whitney U tests, or chi-square tests, as appropriate. At the time of this analysis, 337 patients with CD had received steroids (N=169) or EEN (N=168) as initial induction therapy. Patients in both groups were similar in age (15.0±3.0 years), and gender distribution (approximately 41% female). Preliminary analysis found that, at baseline, those who began EEN had similar disease activity as measured by the Pediatric Crohn’s Disease Activity Index (55.5±23.6) compared to those on steroids (59.3±23.2) (p>0.05). The two groups did show a significant difference in disease location (p=0.01); there was a greater proportion of patients receiving steroids with L4 disease compared to those on EEN (p=0.03). Conversely, there was a greater proportion of patients receiving EEN with L3+L4 disease than those on steroid induction (p=0.01). There was no statistically significant difference between these two groups in school days missed in the last 6 months, extra-intestinal manifestations or perianal involvement. Within the subgroup of patients who had completed IMPACT between three and nine months following induction therapy, HRQOL scores were similar (see table). There were no differences in number of hospitalizations or surgeries within 3 months of IMPACT completion between groups. For pediatric patients receiving either EEN or steroids for induction therapy for CD, there was a significant difference in disease location at baseline, but similar HRQOL outcomes over time. CIHRCH.I.L.D. Foundation
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 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) | 0.002 | 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".