A133 THE INCIDENCE OF DEEP REMISSION INCLUDING HISTOLOGIC NORMALIZATION IN LONGSTANDING UC
Bibliographic record
Abstract
The primary treatment goal in UC is to maintain clinical remission, and endoscopic mucosal healing. Up to 40% of those with mucosal healing have persistent histologic inflammation. Reduced histologic inflammation is associated with decreased risks of relapse, hospitalization, corticosteroid use, colectomy, and neoplasia. Some persons with UC may completely normalize their colon histology. It is unknown what patient characteristics, disease extent, or treatment characteristics are associated with histologic normalization and whether normalization can impact on clinical outcomes. To assess the rate of dysplasia in patients with UC who achieve endoscopic and histologic normalization on at least two consecutive colonoscopies compared to the rest of the cohort. A retrospective chart review was undertaken, of a referral clinic’s patients from 1994 to 2017. Patients included were those diagnosed with UC, with at least 1 colonoscopy undertaken in the referral clinic. Data extracted from the chart included: age, sex, date of diagnosis, date of last follow-up, endoscopic extent of disease, severity of disease, colon histology, medication history, all dysplasia surveillance colonoscopies, and presence/absence of dysplasia. Dedicated GI pathologists then reviewed biopsies to confirm normalization. A total of 350 individuals’ charts were reviewed, with 294 meeting the inclusion criteria. 108 patients had at least 1 normal colonoscopy with normal histology. 28 of these 108 had two consecutive normal colonoscopies and histology. Comparing those with 2 normal colonoscopies to all others (including with 1 normal colonoscopy) there was no statistical difference in the medications used, duration of medications or age at diagnosis, but disease duration was longer for those with 2 consecutive normal colonoscopies (20.5 years vs 15.7, p = 0.02). The mean number of colonoscopies was 5.4 for those with two consecutive normal colonoscopies, vs 3.1 (p<0.001). No dysplasia occurred after 2 consecutive normal endoscopies compared to 18 (6.8%) cases of dysplasia in the comparison cohort. For those with at least one normal colonoscopy, 5 (6.3%) developed dysplasia at some point. Persons who develop deep remission manifested by 2 consecutive colonoscopies with normal endoscopy and normal histology have a lower risk of dysplasia (0 in this cohort). Having 1 colonoscopy with normal histology was not protective against developing dysplasia. In persons with 2 consecutive normal colonoscopies by endoscopy and histology dysplasia surveillance intervals should be lengthened. 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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| 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".