P016 Smoking Status Increases Likelihood of Advanced Disease Phenotype in Crohn’s Disease
Bibliographic record
Abstract
BACKGROUND: The relationship between the smoking status and advanced disease phenotype (stricturing or penetrating) in patients with Crohn's disease (CD) is not well known. This study aims to determine whether smoking status increases the likelihood of advanced disease phenotype in CD patients. METHODS: This was a retrospective study of CD patients seen at McMaster University Medical Centre, in Hamilton, ON, Canada from 2012-2020. Smoking status was dichotomized into two groups, current smokers and ex- or never smokers. Patients were classified as having the primary outcome if their gastroenterologist documented the presence of advanced disease phenotype either during the baseline assessment or during the period of follow-up. Prior knowledge in combination with forward selection was used to develop a multivariate logistic regression model and examine relationships with presence of advanced disease phenotype. The variables considered for the forward selection model included current biologic use, sex, disease duration, disease location, age at diagnosis, and presence of extraintestinal manifestations. RESULTS: A total of 625 CD patients were included in the analysis, of which 186 had stricturing phenotype, 126 had penetrating phenotype and 313 had inflammatory phenotype only. Of the 625 CD patients, 492 had smoking status available – 67 patients were active smokers (13.6%), compared to 85 ex-smokers (17.3%) and 340 non-smokers (69.1%). A univariate regression analysis indicated that the odds ratio (OR) of advanced disease phenotype is 1.80 (95% CI, 1.06 - 3.04) for smokers compared to non/ex-smokers. In the multivariate regression analysis, current biologic use was found to have a significant relationship with advanced phenotype (OR 2.14; 95% CI, 1.47 - 3.11). After adjustment for biologic use, active smokers have 1.93 times higher odds of having advanced phenotype disease (95% CI, 1.11 - 3.35). A sub-analysis of patients with CD penetrating type only displayed smoking (OR 2.01; 95% CI, 1.14 - 3.56) and current biologic use (OR 2.06; 95% CI, 1.33 - 3.18) are significantly associated with penetrating disease. A sub-analysis of patients with CD stricturing type only did not show a significant association with smoking (OR 1.52; 95% CI, 0.88 - 2.62). However, sex [male (OR 1.62; 95% CI, 1.09 - 2.39)] and current biologic use (OR 1.61; 95% CI 1.09 - 2.38) were significantly associated with stricturing disease. CONCLUSION: Current smoking is associated with increased likelihood of advanced disease phenotype in CD patients. Additionally, current biologic use and male sex were found to be have increased odds of advanced phenotype in CD patients. Patients with CD should continue to be advised on the importance of smoking cessation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".