Mo1342 A Concept Recognition Tool to Identify the Surgical Complications of Crohn's Disease in Electronic Health Records
Bibliographic record
Abstract
Background: Previous studies have shown that diagnosis of Crohn's disease (CD) in childhood is associated with a different phenotype when compared to adults (higher risk for ileocolonic disease and fibrostenotic behavior), and may be associated with a more aggressive form of disease requiring more surgery. Those diagnosed at an older age have been reported to have an increased rate of isolated colonic disease and a milder course of disease requiring less surgery. Methods: A comprehensive medical chart review was done for 571 CD patients that were followed in a tertiary referral IBD clinic. Among the parameters that were recorded for each patient at specific time intervals were parameters of disease phenotype according to the Montreal Classification (A1 diagnosed ,16, n=88, A2 diagnosed 16-40, n=287, A3 diagnosed .40, n=77) as well as having surgery. Results: The study included 452 patients that had complete data in the charts. At 6 years from diagnosis and at last follow-up (median11 years), A3 had a higher rate of isolated colonic disease than A1 but not in comparison to A2. Perianal involvement was significantly less common in A3 than A1 or A2. Complicated disease behavior (B2/B3) was similar for all three groups at both time frames. Nonetheless, at 6 years and last follow-up, IBD-related abdominal surgery rates were significantly lower for A1 vs. A2 and vs A3. Conclusions: While there are some disease location differences that emerge with increasing age of presentation (more isolated colonic disease and less perineal disease) disease behavior over time is similar regardless of age at diagnosis and surgeries were least likely in those diagnosed prior to age 16. Our study did not corroborate a more aggressive course for CD that presents in the pediatric age group. Outcomes at 6 years from diagnosis
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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 | 0.003 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.009 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.011 | 0.002 |
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".