Beliefs and Practices of Canadian and U.S. Physicians Regarding the Use of Probiotics for Gastrointestinal Illnesses
Bibliographic record
Abstract
Introduction: Despite the popularity of probiotics with patients, little is known about their utilization and knowledge among Gastroenterologists (GIs) and Family Physicians (FPs). The Canadian Association of Gastroenterology (CAG) developed a needs assessment (NA) to determine utilization and knowledge patterns. Methods: A NA was developed based on the expert opinions and emailed to the members of the CAG, the American College of Gastroenterology (ACG), and other networks of FPs in the US and CAN. Results: A total of 276 physicians, ˜50% from US and CAN, responded to the NA. Respondents were mainly adult GIs (68%), from all “stages of career”, mostly male and from community/private setting, residing in large cities. Most physicians recommend probiotics to their patients (92%-CAN, 85%-US). The top reason for not recommending probiotics was lack of clinical evidence. Among physicians recommending probiotics, a given probiotic was selected based on clinical evidence of efficacy (70%-CAN; 56%-US), or because of a specific strain (44%-CAN; 48%-US). Top information sources were scientific/clinical literatureand clinical guidelines. Choice of a probiotic was determined mostly by clinical data (89%-CAN; 90%-US), followed by cost of probiotics, their stability, manufacturer credibility and manufacturing quality. Probiotics were most commonly recommended for Irritable Bowel Syndrome (IBS; 77%-CAN; 58%-US), followed by diarrhea (53%-CAN; 46%-US), pouchitis (33%-CAN; 38%-US), and constipation/ulcerative colitis (UC)/dyspepsia (all 5-16%). The actual use of probiotics in patients with specific diseases differed slightly between CAN and US (Table 1). Pills/capsules were the most recommended form of probiotic, mostly containing mixture of bacterial species, followed by Bifidobacterium and Lactobacillus.Rationale for recommending probiotics was based equally on personal belief in benefit and scientific evidence; the key exceptions being pouchitis followed by UC, where scientific evidence prevailed. Doctors felt that marketing had little impact (0-6% of all physicians). While most physicians felt fairly or very well informed (53%-CAN; 67%-US), a significant proportion of respondents (30%-CAN, 22%-US) were only somewhat informed. Conclusion: Probiotics are used commonly among GIs and FPs in CAN and US, mainly to treat functional GI disorders. However, knowledge of clinical data and scientific evidence for use of probiotics is discrepant among physicians in both countries.432 Figure 1. n=number of physicians who recommend probiotics for that indication; All results expressed in %.
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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 | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 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".