P220 CROHN’S DISEASE (CD): The predictive value of Montreal clinical patterns, and biological treatment in a Latin American IBD reference center
Bibliographic record
Abstract
Abstract Background CD is a potencially disabling condition, with high rate of complications and surgical requirement. Biological treatments have revolutionized the CD treatment management, but their efficacy and predictive factors could be influenced for epidemiological and environmental conditions which should be locally analyzed wordly. AIMS to describe by a retrospective study in a Latin American IBD reference center, clinical features of the CD casuistic, predictive Montreal patterns for surgical risk and efficay of biologs and immunosuppressant drugs. Methods Data of CD patients (pts) assisted from 1990-June 2020 (CD duration ≥1 yr), categorized by Montreal classification, and by biological and IMM treatment in the prevention as first mayor surgery. Clinical patterns were evaluated as predictive factors at the basal time (up to 90 days from debut) in: Age at diagnosis (A)A1:≦16yrs, A2:17–40, A3:>40, Behavior (B): nonstricturing nonpenetrating (B1), stricturing (B2), penetrating (B3), perianal disease modifier (p), Location (L): L1: ileal, L2: colonic, L3: ileocolonic, L4: upper G.I. Incidence rates of surgery and preventive treatment efficacy were estimated by a Cox regression model. Results 598 CD pts (M 313, F 285) with mentioned available data, CD median duration 13.9 yr (IQR 7.1–21.2) were analyzed. Montreal patterns A1: n 93 (15.6%), A2: n 335 (56.0%), A3: n 170 (28.4%), B1: n 523 (87.5%), B2: n 52 (8.7%), B3: n 23 (3.8%) L1: 52 (8.7%), L2: n 368 (61.5%), L3: n 176 (29.4%), L4: iUGI: n 2 (0.33%) and L4 combined with L1, L2, L3: n 47 (7.9%) Perianal disease (p) n 286 (47.8%). Biologics (before first surgery) in 202 pts, primary non response in 45 pts. Major surgery was performed in 304/598 pts (50.8%) Kaplan Meier estimates: Major surgery incidence rate was 5.1 per 100 person/yrs. Median survival without surgery: 14.2 yrs. Signifficant variables of Cox model for surgery risk were: B1 HR 1 (reference), B2 HR 3.03 (95%CI 2.14–4.29, p=0.000), B3 HR 3.27 (95%CI 2.03–5.29, p=0.000), L2 HR 1 (reference), L1 HR 2.025 (95%CI 1.37–2.99, p=0.000), L3 HR 2.51 (95%CI 1.95–3.23, p=0.000), A1 HR 1 (reference), A2 HR 1.48 (95%CI 1.05–2.10, p=0.027), A3 HR 1.89 (95%CI 1.27–2.83, p=0.002), Biologics (mainly Anti-TNFs) only induction 1.49 (95%CI 1.005–2.195, p=0.047). Induction plus maintenance HR 0.388 (95% CI 0.27–0.55), p=0.000. Non signifficant variables involved in the risk for surgery were: gender, perianal complication, and IMM treatment. Conclusion In our CD population we found: 1) Montreal patterns associated with surgical risk (fistulizing and stricturing behaviors), ileal and ileocolonic locations, A2, but also A3 (debut beyond 40 yrs). 2) Biologics showed a reduction in surgical risk (induction plus maintenance versus only induction).
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 | 0.000 | 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 | 0.001 | 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".