P725 Trends in biologic use prior to resective surgery for inflammatory bowel disease: A Canadian population-based study
Bibliographic record
Abstract
Abstract Background Despite advances in medical therapy for inflammatory bowel disease (IBD), surgery is required in 50–80% of patients with Crohn’s disease (CD) and 20–30% of patients with ulcerative colitis (UC). Given that fibrostenotic disease may be playing a primary role in patients undergoing resective surgery, practices around biologic administration in this setting need to be clarified. We aimed to describe the pre-operative trends in biologic utilisation for IBD patients undergoing resective surgery. Methods The University of Manitoba IBD Epidemiology Database was used to identify all persons with IBD who underwent resective surgery between April 2005 and 2018. Demographic data were extracted to explore the baseline characteristics of persons on biologic therapy prior to IBD resective surgery. Proportion calculations were used to assess how often a new biologic agent was initiated within 3, 6, and 12 months prior to resective surgery. Results were stratified by type of IBD (UC vs. CD) and disease duration (<3 or ≥3 years) for incident cases. Results A total of 1412 IBD-related resective surgeries were identified from April 2005 to 2018. 67.1% of resective surgeries were performed for CD and 32.9% for UC. Results of analysis are presented below: Conclusion Overall, in Manitoba, rates of biologic initiation or re-start in the pre-operative period for IBD resective surgery are relatively small. Biologic therapy was initiated or re-started more frequently for CD than UC, and when disease duration was less than 3 years. This is reassuring and suggests that physicians are rarely choosing to initiate biologic therapy in futile situations. Work should be performed to see if these findings can be replicated in other practice settings.
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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) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.007 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| 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".