711 Comorbidity Burden Among Patients With Ulcerative Colitis in the United States
Bibliographic record
Abstract
INTRODUCTION: The symptoms and comorbidities associated with ulcerative colitis (UC) add to the disease burden. Long-term assessment of the comorbidities associated with UC is needed. The objective of this study was to evaluate UC-related comorbidities, including opioid use as a proxy for pain diagnosis, among patients in the United States. METHODS: This was a retrospective matched cohort study. Working age adults with UC (≥2 independent claims with a UC diagnosis ≥30 days apart and within 1 year; first UC diagnosis was the index date) and controls without diagnosis for inflammatory bowel disease (IBD; random index date) were identified in a US healthcare claims database (OptumHealth Care Solutions, Inc.) of privately-insured patients (01/1999-03/2017). UC patients were matched 1:5 with non-IBD controls using baseline characteristics, including the Quan-Charlson comorbidity index and cardiovascular disease. Comorbidities during the 12-month baseline period before the index date were reported. During the follow-up, the incidence of new comorbidity, including opioid use, was compared to the non-IBD matched controls by Kaplan-Meier (KM) rate with log-rank test. RESULTS: There were 9,353 UC patients and 46,765 non-IBD matched patients in the study sample. The average age was 46 years old, and 50% of patients were female. At baseline, the symptoms and comorbidities significantly higher in the UC cohort were pain, fatigue, and anemia (Figure 1). During the follow-up, the rate of new cases of cardiovascular disease was significantly higher in the UC compared to the matched non-IBD cohort, reaching 8.8% vs 7.8% at year 6, respectively (Figure 2). The rates of new cases of fatigue (4.7 vs 3.3%), anemia (4.8 vs 1.8%), respiratory disease (2.9 vs 1.8%), and anxiety (4.1 vs 2.6%) were also significantly higher in the UC cohort compared to the non-IBD cohort by year 6 ( P -value < 0.001). Rates of new pain diagnosis or opioid use cases were significantly higher in the UC cohort reaching 70.8% compared to 58.0% in the non-IBD cohort, by year 6 (Figure 3). CONCLUSION: In this large retrospective study with long follow-up, comorbidities occurred more frequently in UC compared to matched non-IBD patients. Notably, the rate of new cases of pain/opioid use was significantly higher in UC patients reaching 70.8% by the end of follow-up. These results suggest that patients with UC also have a higher rate of concurrent comorbidities, which add to the disease burden.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| 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".