A86 CHARACTERIZING THE POST-TRANSFER PERIOD AMONGST PATIENTS WITH PEDIATRIC ONSET IBD: THE IMPACT OF ACADEMIC VS. COMMUNITY ADULT CARE ON EMERGENT HEALTH RESOURCE UTILIZATION
Bibliographic record
Abstract
Patients diagnosed with Inflammatory Bowel Disease (IBD) during childhood require transfer to an adult gastroenterologist, in Ontario usually just prior to their eighteenth birthday. Pediatric Onset IBD (PO-IBD) is a complex phenotype with demonstrated non-compliance risk that may require targeted measures to optimize healthcare outcomes in the adult care setting. The purpose of this study was to determine the impact of post-transfer health care setting (academic vs. community gastroenterologist) on emergent health resource utilization. This was a population-based retrospective cohort study using health care administrative data from Ontario, Canada. A cohort of patients with PO-IBD was identified and health resource utilization during a 2-year pre-transfer period, transfer of care period and 2-year post-transfer period was analyzed. Post-transfer healthcare setting was defined as academic (i.e. gastroenterologists providing care in a university affiliated tertiary care center) vs. community. A third comparator group, loss-to-follow-up, was also identified. The primary outcome of this study comprised Emergency Department (ED) utilization. Secondary outcomes included hospitalizations, surgeries, ambulatory visits, endoscopic investigations and radiological investigations. Overall, there were no significant differences found in ED use, ambulatory care visits (aside from the expected drop in the lost to follow-up group), hospitalizations, endoscopic procedures or radiological procedures between exposure groups. Post-transfer healthcare setting does not appear to significantly impact emergent health resource utilization in the post-transfer period. Univariable Analysis of Select Primary and Secondary Outcomes ED = Emergency Department, GI = Gastroenterology, SD = Standard Deviation CAG
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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 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| 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".