A2 LIFE EXPECTANCY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE (IBD): A POPULATION-BASED MATCHED COHORT STUDY
Bibliographic record
Abstract
The benefits of recent improvements in IBD care on life expectancy (LE) and health-adjusted life expectancy (HALE) are unknown. To compare LE and HALE in people with and without IBD and evaluate the impact of narcotics and IBD medications on LE. Cases of IBD and controls (matched on age, sex, rurality, and income) were identified from health administrative data in Ontario using validated algorithms. Five-year mortality rates and period life tables were used to calculate LE in 1996, 2000, 2008, and 2011. Health Utility Index (HUI) (from the National Population Health Study and Canadian Community Health Survey) is a utility-based measure of health-related quality of life which was combined with period life tables to estimate HALE in 1996, 2000, and 2008. Prescription records from Ontario Drug Benefits (for patients ≥65 y old) and Narcotic Monitoring System (all ages) were used to determine the effect of medications on LE. LE significantly increased from 75.5y to 78.4y (Δ2.9y, 95%CI 1.3 to 4.5) in females and from 72.2y to 75.5y (Δ3.2y, 95%CI 2.1 to 4.4) in males with IBD (Figure). HALE was stable over time in females (Δ2.0y, 95%CI -1.6 to 5.7; 1996: 62.3y; 2008: 64.3y) but decreased in males (Δ-3.9y, 95%CI -6.6 to -1.2; 1996: 67.0y; 2008: 63.1y) with IBD. Both LE and HALE were significantly lower in those with IBD than controls (LE: females Δ6.6–8.1y, males Δ5.0–6.1y; HALE: females Δ9.5–13.5y, males Δ2.6–6.7y). Opioid use reduced life expectancy (chronic vs. non-users: females Δ-22.1, 95%CI -25.0 to -19.2; males Δ-36.0y, 95%CI -62.4 to -9.7; non-chronic vs. non-users: females -4.7, 95%CI -6.4 to -3.0; males Δ-2.7y, 95%CI -3.8 to -1.6). Systemic steroids, opioids, and their combination shortened LE and mesalamine lengthened LE in IBD patients ≥65y (see Table). Although LE increased over time in patients with IBD, the gap in LE between those with and without IBD remained significant. Increases in LE were not accompanied by increased HALE. Use of steroids and opioids had very negative consequences on LE. Decisions with regard to treatment strategies for patients with IBD should incorporate data on the differences in LE for different treatment groups. Differences in the life expectancy (95% CI) among patients receiving the medication in the column name subtracted from the row name F, female; M, male Life expectancy and health-adjusted life expectancy in patients with IBD and matched controls CAG, CCC, CIHR
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".