PWE-052 Current practices in ileal pouch surveillance for ulcerative colitis patients in three london ibd referral centres
Bibliographic record
Abstract
Introduction There are no universally accepted guidelines regarding surveillance of IBD patients after ileal pouch-anal anastomosis (IPAA). The BSG suggest ‘considering’ pouchoscopy and biopsy but accepts ‘there is no clear evidence that surveillance is beneficial and thus it cannot be strongly recommended’. We assessed how frequently pouch surveillance is carried out at our centres. We also evaluated the approaches used for pouchoscopy and the use of endoscopic biopsies. Method The records of 177 patients who underwent IPAA for IBD at three London IBD referral centres (Guy’s and St Thomas’, University College London and St Mark’s Hospitals) were reviewed. Patients with Crohn’s or less than 1 year post-surgical follow-up, were excluded. Data regarding the endoscopic follow-up of the remaining 126 patients was collected retrospectively. Fisher’s exact (categorical) and signed rank sum (continuous) tests were used. Results 15/126 (12%) had never undergone pouchoscopy for any indication. Of the 111 who had, the median interval between pouch surgery and first pouchoscopy was 1.3 years (0.2–6.4). Median number of pouchoscopies was 3 (0–11), carried out at a median frequency of every 2.4 years (0.9–8.1). Two rectal cuff cancers were found. 59/126 (47%) had never undergone pouchoscopy with surveillance as the sole indication and no significant differences were found between sub-groups. Median pouch duration 7.1y surveillance, 8.4y none (p=0.193). Gastro, Surgery and joint-care surveillance rates: 7/16 (44%), 28/46 (61%) and 32/64 (50%), respectively (p=0.382). Pouchitis history surveillance rates: present 29/51 (57%), absent 36/73 (49%)(p=0.501). Rates of examination and biopsy by pouch region shown in fig 1. Conclusion We demonstrated wide variation in endoscopic surveillance of UC-IPAA patients, even amongst experienced clinicians. Some patients underwent several pouchoscopies for surveillance, whereas others had none. In additional, the decision whether to perform surveillance pouchoscopy did not seem to be related to risk factors such as pouch duration. Moreover, endoscopic pouch assessments could be considered incomplete in a proportion of patients with no description of the prepouch ileum or rectal cuff/anal transition zone. Disclosure of Interest None Declared
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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 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".