P277 Nutritional status and disease activity in crohn’s disease: preliminary data
Bibliographic record
Abstract
Introduction Malnutrition is a highly prevalent and crucial complication of Crohn’s Disease (CD), even in patients in remission; nevertheless assessment and treatment of malnutrition is rarely integrated into management plans. Body Mass Index (BMI) and Malnutrition Universal Screening Tool (MUST) are widely used, but not exempt of limitations. Objectives To investigate (1) the prevalence of malnutrition in an outpatient sample of CD patients, using the most frequent and recommended nutritional tools in clinical practice (2) the existence of any relationships between nutritional and clinical status in patients with CD, and (3) the reliability and validity of different methods of nutritional assessment in patients with CD in an ambulatory setting. Methods Cross-sectional, observational study that took place in the IBD outpatient clinic at University College Hospital between March and June 2019. Demographic (gender, ethnicity, age and smoking status), and disease activity data (Harvey Bradshaw Index, Montreal Classification, past surgical history, current and past medication) were collected. Nutritional assessment was performed, using weight, height, BMI, MUST, Mid-upper arm circumference (MUAC) and Hand Grip Strength (HGS). Additionally, blood biochemistry was recorded. Results 86 consecutive CD patients were included (38 female; mean age 38.5±15.3 years; 19 Asian, 67 of white ethnicity; 62 non-smokers, 13 smokers and 11 ex-smokers).Statistically significant positive associations were found between clinical activity (HBI) and MUST (r=0.426, r²=0.18, p<0.05), CRP (r=0.282, r²=0.079, p<0.05) and Platelet values (r=0.24, r²=0.079, p<0.05). A significant positive association was found between MUST and CRP (r=0.29, r²=0.08, p=0.0049) and negative between MUST and BMI (r=0.43, r²=0.19, p=0.000002).No significant association was found between the other parameters collected. In the sub analysis comparing active (HBI≥5; n=40) vs remission group (HB<5; n=46), there was a trend for a lower mean HGS in the active group (29.58±11.89 vs 33.94±12.66; p=0.1). MUST score 0 was more prevalent in patients in remission compared with active (n=31 vs n=22; p<0.005) and MUST score 1 was more common in the active group (n=13 vs n=7; p<0.005). The prevalence of malnutrition was 12.5% in the active group, and 17.3% in the remission group, when calculated with MUST; and 22.5% in the active group and 8.69% in the remission group by BMI criteria. Conclusions Malnutrition rates are high in patients with CD, even in remission. HGS was lower in the active group while MUST was negatively associated with BMI. Malnutrition screening and assessment should be included routinely in IBD clinical practice. Further data are being collected based on body composition.
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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 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".