Do Quality of Life and Disease Activity in Inflammatory Bowel Disease Differ by Race in a Tertiary Referral Practice?
Bibliographic record
Abstract
Purpose: To assess for racial differences in quality of life and disease activity among patients with inflammatory bowel disease (IBD). Baseline characteristics such as gender, age at diagnosis, disease location and disease behavior were also compared. Methods: The University of Maryland Inflammatory Bowel Disease Program Clinical Database documents demography, phenotype, quality of life and disease activity scores at each visit for all outpatients with IBD. We identified all Caucasian and African American (AA) patients having ≥2 encounters with recorded scores for the Short Form-Inflammatory Bowel Disease Questionnaire (SIBDQ) and disease activity indices from 2004-2009. The Harvey Bradshaw Index (HBI) was used for Crohn's disease (CD) and Simple Clinical Colitis Activity Index (SCCAI) for ulcerative colitis (UC) patients. We compared mean SIBDQ, HBI and SCCAI scores by race. We performed linear regression for the UC and CD cohorts to evaluate the association between race and mean SIBDQ scores. Models controlled for gender, age at diagnosis, disease location and disease phenotype (using Montreal update of Vienna Classification). Results: The database query yielded 291 IBD patients meeting criteria. Of these, 194 (67%) had CD and 97 (33%) had UC; 238 (82%) were Caucasian and 53 (18%) were AA. No differences were seen in mean SIBDQ, HBI or SCCAI scores by race in the unadjusted analyses. In CD patients, females had a mean SIBDQ score that was 8.8 points (95% CI -12.3, -5.3) lower than males, while stricturing phenotype patients had a mean SIBDQ score that was 5.3 points (95% CI -9.6, -1.1) lower than non-stricturing, non-penetrating phenotype patients in the adjusted analysis. Additionally, for each 1 year increase in age at diagnosis, the mean SIBDQ score decreased 0.50 points (95% CI -0.98, -0.01) in AAs, a trend not seen in Caucasians. In UC patients, AA males had a mean SIBDQ score that was 10 points (95% CI 3.7, 16.3) higher than Caucasian males while AA females had a mean SIBDQ score that was 6.6 points lower (95% CI -13.6, 0.33) than Caucasian females in the adjusted analysis. Higher adjusted mean SIBDQ scores were also seen in UC patients with E2 (+ 6.3 points; 95% CI 0.02-12.6) and E3 (+ 8.5 points; 95% CI 2.44-14.5) compared to E1 disease extent. Conclusion: In a CD referral cohort, mean SIBDQ scores decreased with increasing age at diagnosis among AA, but not Caucasians. In a UC referral cohort, mean SIBDQ scores were higher in AA men but lower in AA women compared to their Caucasian counterparts. No racial differences in mean SCCAI or HBI scores were seen. This research was supported by an industry grant from Procter and Gamble.
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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 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| 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".