P542 Clinical presentation, disease behavior and management of inflammatory bowel disease at extremes of age
Bibliographic record
Abstract
Abstract Background The natural history of patients with Montreal classification A2 group is well studied. Available studies on disease characteristics at extreme ages, which form 10%-25% of patients with IBD, focused on pediatric or elderly population, but not all age groups together.1 We aimed to compare the disease characteristics of pediatric- (≤16 years, P) and elderly- (≥60 years, E) onset IBD with 17-59Y middle aged group (M). Methods 266 consecutive patients with IBD were divided into 3 groups according to age of onset. Information about disease location, extent, behavior and need for immunosuppressants / biologics and surgery was entered in pro-forma. Results The table shows details of 258 (P 46, M 170, E 42) patients. 8 IBD-unclassified patients were not included in the analysis as numbers were too small to compare the differences. Among UC patients, pancolitis was more common in the pediatric population (p=0.018) and indolent behavior was more common in elderly population (p=0.005). Almost all UC patients requiring colectomy had extensive colitis(p=0.008). While among CD patients, elderly had more of ileal (p=0.04) and pediatric group had more colonic involvement (p=0.02). Perianal disease was least common in elderly CD group (p=0.03). There were no treatment differences in UC patient subgroups while elderly CD patients less frequently required steroids, biologics, immunosuppressants and surgery(p<0.05) and younger CD patients needed biologics much more frequently (p=0.005). Conclusion Pediatric UC had more pancolitis(E3) while elderly UC had milder disease with EIM less frequently. Significant co-relation was noted between colectomy and extensive colitis. Pediatric CD patients had more colonic (L2) disease with more requirement of biologics, while elderly CD group had more common ileal (L1) disease, least common perianal disease and less requirement of all treatment modalities when compared to adults. This study highlights possible different Indian IBD disease spectrum in contrast to Western literature. 1. Nimmons D, Limdi JK. Elderly patients and inflammatory bowel disease. World J Gastrointest Pharmacol Ther. 2016;7:51–65.
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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 | 0.001 | 0.001 |
| 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) | 0.004 | 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".