N001. Telephone vs clinic follow-up in the management of patients with inflammatory bowel disease: a nurse practitioner-led study
Bibliographic record
Abstract
Background: Management of inflammatory bowel disease (IBD) requires frequent contact with health care providers, but clinic visits impose an economic burden and can cause psychosocial distress.This study examines the effectiveness of telephone contact versus a clinic appointment amongst patients followed for IBD.Methods: This is a mixed method study design.Consecutive IBD patients were randomly assigned to either clinic follow-up visit (CFV) by an IBD nurse practitioner or telephone follow-up visit (TFV) with an IBD nurse practitioner 3 months after their current appointment.Standardised questionnaires, including demographics, IBD phenotype, disease activity, medication, quality of life, resource utilisation, anxiety, and depression were completed at baseline and 6 months visits using an on-line survey.Patient satisfaction and preference were evaluated in focus group sessions.Results: Sixty patients were recruited from the outpatient clinic at McMaster Medical Centre.There were no differences in the basic demographic between both groups (Table 1).The average parking and travel costs for patients randomised to CFV were CAN $25.83, and their average loss of income was CAN $17.00.The median duration of health care contact was longer in the CFV group (52 minutes vs 17 minutes [IQR 15.0-21.2];p = <0.01),with wait time was longer in CFV (median 31.6 minutes [IQR 8-56] vs 0 minutes p < 0.01).Rates of interim health care contact did not differ between the 2 arms.No significant change in health-related quality of life (Short Inflammatory Bowel Disease Questionnaire) or satisfaction (Patient Satisfaction Questionnaire) from baseline to 6-month followup was observed.There was also no significant change in C-reactive protein (CRP), Harvey-Bradshaw Index (Crohn's disease) or Partial Mayo Score (ulcerative colitis).At 6 months, subjects in the TFV arm had lower median total HADS score (8 vs 12, p = 0.045) and lower median HADS depression score (p = 0.046).A common theme mentioned by TFV subjects in focus groups was their satisfaction with time and money saved via telephone communication.Depending on their circumstances, the patients preferred telephone visits when in remission and clinic visits during relapse of their disease.Conclusions: Our feasibility study has shown that telephone visit is cost saving and preferred by patients with IBD.This mode of follow-up care was also associated with better anxiety and depression scores.Further research is needed to explore how TFV can best be integrated in patient management algorithms.
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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 | 0.007 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.018 | 0.003 |
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".