P252. Fulminant hepatic failure requiring transplantation after initiation of infliximab therapy in Ulcerative Colitis
Bibliographic record
Abstract
Background: IBD patients are still under-diagnosed or diagnosed with serious delay.The aim of our study was to examine whether diagnostic delay in IBD has changed over the last thirty-three years and to investigate its correlation with Crohn's disease (CD) phenotype and Ulcerative Colitis (UC) location at diagnosis.Methods: Cases included all IBD patients recorded in the registry of four IBD referral Centres in Italy.Diagnostic delay was calculated from the onset of the symptoms indicative of CD or UC to the definitive diagnosis.Data reported included date of birth, gender, IBD location and CD behavior at diagnosis, according to the Montreal classification.Results: Of 3393 IBD patients, 2499 (74%) had a diagnostic delay ≥ 1 month, 1046 (31%) ≥ 12 month.Median diagnostic delay was 3 months (7 months in CD e 2 months in UC).Mean diagnostic delay was 19 month, standard deviation (SD) 45, (significantly higher in CD than UC, 29 vs 11 months,SD 54 vs 34, p<0.0005).In CD, mean diagnostic delay was higher in patients with penetrating/stricturing behavior at diagnosis (n=870) compared to patients with inflammatory behavior at diagnosis (n=667), (32 vs 23 month,SD 49 vs 57, p<0.0005).242 patients were diagnosed between 1952-1979 (historical cohort), while 3151 were diagnosed between 1980 and 2013 (modern cohort).Mean diagnostic delay was significantly higher in the historical cohort in comparison to the modern cohort (31 vs 18 month,SD 58 vs 44, p<0.0005).IBD patients belonging to the modern cohort were stratified according to the time of diagnosis into three subgroups (1980-89, 1990-99, 2000-13).There was no significant difference in the mean diagnostic delay between the three periods (18, 17 and 19 months, SD 41,37 and 50 respectively).No significant difference was found in the mean diagnostic delay according to gender or disease location at diagnosis.Conclusions: Diagnostic delay in IBD was significantly decreased in recent years in comparison to the past , however it did not change over the last thirty-three years, despite increasing the diagnostic tools.Compared with UC, diagnostic delay is higher in CD, especially in patients with penetrating/stricturing behavior at diagnosis.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".