P282 Influence of phenotype at diagnosis and of other potential prognostic factors on the prognosis of Crohn’s Disease in Chinese population
Bibliographic record
Abstract
Abstract Background L4 Crohn’s disease (CD) is defined as any lesion location proximal to terminal ileum according to Montreal classification. L4 disease was considered to associated with poor prognosis. However, the outcome of CD patients with esophagogastroduodenal disease and small intestinal lesions remains to clarified. Our aim was to confirm whether the outcome diffs among the patients with different L4 disease. Methods Our study included 670 patients who confirmed CD between January 2014 and December 2020 retrospectively. As similar as Paris classification, we divide L4-disease in adult into L4a and L4b with a ligament of Treitz as a boundary. The primary outcome was defined as intestinal surgery. Clinical manifestation and outcomes were compared among L4a, L4b, and non-L4 disease. Results Totally 237(10.0%) patients had isolated L4 disease or L4 disease concomitant non-L4 disease. Among them, 67(10.0%) patients suffered from L4a disease and 168(25.1%) patients has a L4b disease. Patients with L4b disease were more likely to undergo intestinal surgery compared to L4a and non-L4 disease (41.7% versus 9.0% and 21.8%, respectively, both p<0.0001). However, L4a wasn’t a risk factor for intestinal surgery than non-L4 disease(9% versus 21.8%, p=0.074). At diagnosis, L4b group has a higher percentage of intestinal obstruction than L4-GD and non-L4 group (39.3% versus 17.9% and 22.4%, respectively, p=0.0021 and p<0.0001). Results of multivariate analysis also showed that intestinal obstruction at diagnosis, disease behavior and disease location was a independent predictors for intestinal resection, and L4b (HR 1.786; 95%CI 1.302–2.303, p=0.0032) show significant differences between non-L4 disease. Conclusion Within L4 disease, L4b disease was a risk factor associated a poor prognosis compared to non-L4 disease. But the same result can’t be found in L4a disease. It might indicate that we need divide L4 phenotype of Montreal classification into L4a subgroup and L4b subgroup, and treat patients with L4-intestnal disease with biological agents earlier.
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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 | 0.001 | 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) | 0.003 | 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".