Further Characterization of Painful Functional Constipation (PFC)
Bibliographic record
Abstract
Purpose: Patients with painful functional constipation (PFC) differ from those with painless constipation in having poorer health related quality of life and more somatic symptoms (Bharucha Am J Gastro, 2006). The aim was to further characterize clinical features of PFC over time and relative to IBS, another painful disorder. We sought to: 1) compare PFC with IBS and its subtypes, 2) determine clinical features of PFC over time, and 3) compare PFC patients with high (HP) and low (LP) pain scores. Methods: From 231 women in an NIH trial, Rome II moderate to severe PFC (n = 41), IBS-A (n = 55), IBS-C (varies between IBS-C or IBS-mixed over 1 year; n = 80) and IBS-D (between IBS-D or IBS-mixed; n = 55) received diary cards on stool frequency, consistency and pain (VAS) daily for 14 days pre-and post 12-wk treatment and at 3-mo intervals for 1 yr. PFC was characterized into HP and LP groups by a median split of VAS pain scores. Descriptive statistics were calculated, and comparisons performed by χχ2 for categorical and t-tests for continuous variables. Linear regression and repeated measures tested between- and within-group associations respectively. Results: a) PFC differs from IBS with: higher pain scores (p= 0.002), lower education (p= 0.02), greater health care use and surgeries (p= 0.05 to 0.003), and poorer daily function (SIP Overall p= 0.004), b) PFC is similar to IBS-C and IBS-A but different from IBS-D for stool frequency and consistency (p < 0.0001), bloating (p= 0.02), laxative/antidiarrheal use (p= 0.04 and 0.02) and lower education (p= 0.02). c) Over 1 year, PFC: maintained higher pain scores than IBS, had stool frequencies less than IBS-D and between IBS-C and IBS-A, had stool consistency less than IBS-D and similar to IBS-A, d) For HP and LP PFC there was no difference in constipation, and HP switched to LP over time, while LP stayed low. Limitations include the absence of a painless constipation group, and studying moderate to severe symptoms which may not represent all with PFC or IBS. Conclusions: PFC is clinically similar in stool pattern and bloating to IBS-C and IBS-A, but different from IBS with greater pain, health care utilization and poorer daily function. Over 1 year, stool frequency/consistency of PFC is stable, but HP scores decrease. Supported by NIH: RO1DK49334 and R24 DK067674, GCRC 000024 and Novartis Pharmaceuticals
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".