P811 A watchful approach for newly diagnosed Crohn’s disease patients with an inflammatory phenotype
Bibliographic record
Abstract
Abstract Background Early treat-to-target approach in Crohn’s disease (CD) patients is recommended to avoid complications. However, CD may not progress in all patients, despite lack of treatment or 5-ASA medications use, exposing this group of patients to unnecessary side effects if treated according to guidelines. We aimed to examine whether newly diagnosed CD patients with an inflammatory phenotype can benefit from a watchful approach. Methods This was a retrospective cohort study following CD patients at a tertiary centre, who were diagnosed between 2010 and 2015 and were followed for at least 1 year. Only patients with an inflammatory phenotype (Montreal classification B1) were included. Epidemiologic, clinical and endoscopic data was retrieved from medical records. A watchful approach was defined as maintenance therapy with 5-ASA medication only or no treatment at all during first year of diagnosis or further. Disease complications were defined as surgery or change in disease phenotype. Results Thirty-seven patients, (35.1% males at a mean age of 41.4 ± 19.6 years) were included in the study. During the follow-up period of 54.9 ± 28.7 months, 31 patients (86.0%) did not develop disease complications. The patients were characterised by females predominance (83.3% vs. 25.8%, p = 0.007), less smokers (25.8% vs. 83.3%, p = 0.006), earlier diagnosis from symptom onset (9.6 ± 15.6 months vs. 49.8 ± 57.0 months, p = 0.001) and prednisone therapy at diagnosis (87.1% vs. 50.0%, p = 0.032), compared with the patients that developed complications. There was no difference in clinical disease severity (HBI score 2.9 ± 1.5 vs. 3.1 ± 0.9, p = 0.721) or endoscopic activity (SES-CD score 6.3 ± 4.8 vs. 5.0 ± 4.8, p = 0.528) at diagnosis. Only 22.6% (7/31) of the patients were eventually treated with thiopurines or biologics for disease exacerbation. Conclusion A watchful approach of newly diagnosed CD patients with an inflammatory phenotype can be considered, especially in non-smoking women. This sub-group should be further characterised.
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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 | 0.000 | 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".