A116 CLINICAL OUTCOMES OF PATIENTS UNDERGOING BALLOON-ASSISTED ENDOSCOPY FOR SUSPECTED SMALL BOWEL BLEEDING
Bibliographic record
Abstract
Abstract Background Obscure gastrointestinal bleeding (OGIB) accounts for approximately 50% of all GI bleeds. This refers to bleeding from an unknown etiology despite initial investigations with upper endoscopy and colonoscopy, of which 75–80% is attributed to a small bowel source, also termed as small bowel bleeding. Various diagnostic and therapeutic modalities have been used to investigate sources of OGIB. Balloon-assisted enteroscopy (BAE) is a useful procedure for managing small bowel bleeding, with reported diagnostic and therapeutic rates up to 87% and 80%, respectively. Aims The aims of this study are to evaluate the outcomes of patients with OGIB who have undergone BAE, as well as to explore correlations between the timing of BAE and clinical outcomes. Methods We performed a retrospective review of 342 patients who underwent BAE at a tertiary referral centre between 2016 to 2021, of which 116 underwent evaluation for OGIB. Aside from gender and age, preprocedural variables including endoscopy indication, timing from video capsule endoscopy (VCE) and overt GI bleed were collected to allow for further stratification of data. Endoscopic variables including modality, findings, and therapeutic interventions were used to calculate diagnostic and therapeutic yields. Furthermore, the association between timing of BAE after VCE and clinical outcomes including rebleeding rate, diagnostics and therapeutic yields were assessed. All data analyses were performed with SPSS. Results The overall diagnostic yield was 70.3%. Patients with active overt bleeding were found to have a higher yield compared to those with occult and inactive overt bleeding (78.6% vs 72.5% vs 64.6%, respectively). Amongst all OGIB presentations, the most common findings were vascular lesions including angiodysplasia, arteriovenous malformations, and dieulafoy lesions. The majority of lesions were found within the proximal jejunum. Subgroup analysis did not show a statistically significant difference in diagnostic yields between BAE with and without prior VCE (75.9% vs 77.8, P = 0.605). The therapeutic yield was 51.1% with a higher yield found in those presenting with active overt bleeds compared to occult and inactive overt cases. Compared to BAE performed after 30 days of overt GI bleeding, those completed within 30 days was found to have a higher diagnostic and therapeutic rate (80.0% vs 60.0%, 70.0 vs 30.0%, respectively). Conclusions Balloon-assisted enteroscopy continues to be an effective diagnostic and therapeutic modality for the investigation of obscure gastrointestinal bleeding. Our retrospective study shows a higher diagnostic and therapeutic rate in those presenting with active overt GI bleed as well as those who underwent BAE within 30 days of overt GI bleeding Funding Agencies None
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| 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".