P628 Histological remission does not offer additional benefit for ulcerative colitis patients in endoscopic remission
Bibliographic record
Abstract
Abstract Background Histologic remission appears to be associated with positive outcomes in ulcerative colitis (UC) patients. However, it is not clear whether UC patients in endoscopic remission have additional benefit from achieving histologic remission. The objective of the study was to assess the relationship between time to relapse and histological activity among UC patients who are in endoscopic remission. Methods This was a retrospective observational study conducted at McMaster University Medical Centre in Hamilton, ON, Canada and University of Chicago Hospital, Chicago, IL. UC patients from an ongoing observational database who had achieved endoscopic remission (Mayo score 0) were included. Index colonoscopy was the first colonoscopy where Mayo 0 was achieved. These patients were classified based on their histologic activity: normal (no architectural changes or evidence of UC), inactive colitis (architectural changes but absence of acute inflammation), or active colitis (neutrophils in epithelium, crypt destruction, and/or erosions/ulcers). The primary outcome was time to relapse (defined as symptomatic flare with escalation of medical therapy, UC-related hospitalisation, colectomy, or development of colorectal cancer/dysplasia). Secondary outcomes included reasons for relapse and the association between other baseline variables and risk of relapse. A Cox proportional hazards model was used to evaluate the association of baseline factors with the outcome of relapse. Results 269 patients with UC and endoscopic remission were included in this study. According to a Kaplan–Meier survival curve analysis, there was no significant difference based on histologic activity with regards to time to relapse (log-rank p = 0.96)(See Figure). Patients with active colitis on histology did not have a higher relapse rate compared with those with inactive colitis (hazard ratio 1.11, p = 0.77), after adjustment for covariates. Older age, 5-aminosalicylate use, and disease location (both left-sided and pan-colitis) were found to be significantly associated with a lower rate of relapse. Symptomatic flare with an escalation of medical therapy accounted for the majority of relapses (80.4%). Conclusion Histologic remission did not impact time to relapse in UC patients who had achieved endoscopic remission. This suggests against targeting histologic remission in patients who have achieved endoscopic remission.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".