P396 COVID-19 pandemic-related endoscopy delays did not translate to deleterious outcomes for patients with Inflammatory Bowel Disease: A retrospective cohort study
Bibliographic record
Abstract
Abstract Background Inflammatory Bowel Disease (IBD) patients require frequent endoscopies for disease assessment and confirmation of remission, making it a crucial component in their management. It is unknown if measures put in place to reduce the spread of the virus SARS-CoV-2, including the delay of non-urgent IBD patient endoscopy, resulted in more deleterious outcomes for patients with IBD. Therefore, we aimed to determine if delays in endoscopy during the COVID-19 pandemic were associated with an increased risk of adverse IBD outcomes (emergency room, ER presentation, hospitalization, surgery or escalation of drug therapy). Methods A retrospective cohort study was performed in IBD patients receiving outpatient endoscopies between March and August, 2019 (pre-COVID-19 pandemic) and, 2020 (during the COVID-19 pandemic) at two tertiary care centers affiliated with Western University, London, Canada. Data pertaining to endoscopy timing, IBD drug prescription, ER attendance, hospitalization, and surgery were collected. Results A total of, 1160 endoscopies (2019, n=718;, 2020, n=442) occurred across, 1083 patients (2019, n=669;, 2020, n=414). More endoscopies were delayed in, 2020 than, 2019 (26.7% vs., 9.7% respectively, p<0.0001) and for longer, 56 days (IQR=63) in, 2020 vs., 30 days (IQR=42) in, 2019. No differences were seen in the baseline demographic characteristics based on cohort year or occurrence of endoscopy delay. Also, rurality, sex, IBD type, and age were not associated with a delay in endoscopy. It was found that endoscopy delay was not associated with an increased risk of an adverse IBD outcome (composite outcome of emergency room presentation, ER presentation, hospitalization, surgery or escalation of drug therapy) (RR, 1.23, p=0.20). Conclusion A greater proportion of delays in endoscopy were observed during the COVID-19 pandemic; however, delays in general were not associated with more adverse IBD outcomes, and were found to be associated with less deleterious IBD outcomes. This may reflect the accurate and preferential triage of more severe IBD patients to endoscopic assessments.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".