S186 Variation in Colectomy Rates in Ulcerative Colitis
Bibliographic record
Abstract
Introduction: Data regarding inter-regional colectomy rates in patients with ulcerative colitis (UC) remains largely unknown. Herein, we sought to systematically review the global variation in the rates of colectomy in patients with UC. Methods: A comprehensive search analysis was performed using the electronic databases MEDLINE/PubMed, EMBASE, and Cochrane through May 2020, to identify all full-text, randomized controlled trials (RCTs) and cohort studies pertaining to colectomy rates in adult patients with UC. We followed PRISMA and AMSTAR 2 guidance for conducting our systematic review. Outcomes included continent based demographic data and variation in colectomy rates. All articles were screened for bias using the Newcastle-Ottawa Scale. To identify the region-specific proportion of patients undergoing colectomy, data were plotted and median overall proportions were generated. Results: Our literature search identified 1249 articles, of which 77 studies met inclusion criteria and were eligible for review. The median overall proportion of persons with UC whom underwent a colectomy in studies was 17% (range: 1.6%-71%). Median age at UC diagnosis was scarcely reported and could not be adequately assessed. While the median proportion of persons with UC whom underwent colectomy was 38%, 31%, and 14% in Oceania, North America, and Europe respectively; Africa, Asia, and South America saw median colectomy rates as low as 10%, 8%, and 3%, respectively (Table). Conclusion: Considerable inter-regional differences were observed regarding colectomy rates in patients with UC. As such, the development of homogenous evidence-based guidelines accounting for the geographic differences in managing patients with UC is needed. Additionally, as a paucity of data on colectomy exists outside the North American and European continents, future studies—particularly in less studied locales—are warranted. Table 1. - Continent based Ulcerative Colitis (UC) colectomy rates Region N studies N sample size (median, range) Proportion males (median, range) N colectomy (median, range) Proportion colectomy (median, range) North America 20 429 (26-443,043) 51% (39%-66%) 176 (9-19,208) 31% (4%-58%) Europe 41 474 (30-76,129) 53% (0%-88%) 37 (10-9118) 14% (2%-71%) Asia 10 175.5 (62-1013) 54% (49%-59%) 20 (3-61) 8% (16%-47%) Oceania 3 71 (15-225) 61% (55%-67%) 22 (9-86) 38% (31%-60%) Africa 2 125 (115-135) 45% (44%-47%) 12 (4-20) 10% (3%-17%) South America 1 267 33% 9 3%
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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 | 0.020 | 0.087 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.005 |
| Bibliometrics | 0.015 | 0.019 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 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".