A103 META-ANALYSIS: NEOPLASIA OF THE POUCH IN PATIENTS WITH ULCERATIVE COLITIS POST ILEAL POUCH-ANAL ANASTOMOSIS
Bibliographic record
Abstract
Abstract Background Ileal anal pouch anastomosis (IPAA) is often used for patients with severe ulcerative colitis that is refractory to medical treatment or for patients with neoplasia/dysplasia to maintain intestinal continuity. Patients with ulcerative colitis have an increased risk of developing dysplasia or colorectal cancer compared to the general population, however the need for pouch surveillance is debated. A meta-analysis was performed to identify the risk and prevalence of pouch related malignancy in patient with ulcerative colitis following IPAA. Aims Our aim is to assess of the rate of dysplasia and malignancy post IPAA in patients with ulcerative colitis and also assess what the factors associated with developing malignancy post IPAA Methods A search of Embase and Ovid MEDLINE was conducted to identify studies from 2014 to June 2021 that reported the incidence of dysplasia or malignancy following IPAA in patients with ulcerative colitis. Abstracts and conferences were not included in the search. The studies were assessed for relevance and data were extracted independently by two reviewers. Results This analysis included 11, 268 patients with variable follow-up. The evidence was graded as low-certainty due to significant heterogeneity and low-quality studies. The pooled prevalence of carcinoma or dysplasia (low or high grade) in pouch or the rectal cuff was 0.4% [95% CI 0.2- 0.7]. However, in patients with prior colectomy for colorectal cancer the odds ratio was 32.20 [95% CI 15.58 - 66.53] for pouch malignancy. Significant heterogeneity and variability of the pooled studies was identified (I2 = 77.5%). Conclusions Although the rate of dysplasia or malignancy was 0.4% for all IPAA, the odds ratio for these outcomes in patients with IPAA for prior malignancy was 32.20 [95% CI 15.58 - 66.53]. Further studies are required to validate these findings. 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 | 0.017 | 0.035 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.059 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 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".