P278 Endoscopic scoring system utilization for Inflammatory Bowel Disease activity assessment: a multicenter real-world evidence study from Argentina (DARE study)
Bibliographic record
Abstract
Abstract Background The use of scores for the assessment of endoscopic activity in inflammatory bowel disease (IBD) patients is crucial for accurate and reproducible evaluation of mucosal healing, which is a relevant marker of prognosis. Frequency and patterns of their use in a real-life setting are not known. We aimed to describe the prevalence of adequate use of endoscopic scores in IBD patients who underwent colonoscopy in a real-life setting. Methods A multicenter observational study comprising six community hospitals in Argentina was undertaken. Patients with a diagnosis of Crohn’s disease or ulcerative colitis who underwent colonoscopy for endoscopic activity assessment between July 2018 and July 2022 were included. Colonoscopy reports of included subjects were manually reviewed to determine the proportion of colonoscopies that included an endoscopic score report. We compared the endoscopic findings to determine if there were differences in the score reported and the inflammatory activity described. Finally, we determined the proportion of colonoscopy reports that included all of the IBD colonoscopy report quality elements proposed by BRIDGe group. Endoscopist’s specialty, years of experience as well as expertise in IBD were assessed. Chi square test was used for the comparison of categorical variables; Student t test for the comparison of numerical variables. A multivariate analysis was performed using a logistic regression model. A p value of less than 0.05 was considered to be statistically significant. Results A total of 1206 patients were included for analysis (32.25% patients with Crohn’s disease). Mean age was 45.48±15.6. Endoscopic score reporting was found in only 34.45% of Crohn’s disease colonoscopies and in 52.87% of ulcerative colitis colonoscopies. Most frequently used scores were Mayo endoscopic score (90.56%) and SES-CD (56.03%). We found discrepancies between the score reported and the findings described in colonoscopies in 10.92% of cases; only 26% of reports included all recommendations proposed by BRIDGe group. On multivariate analysis, surgeons as operators [OR 0.08 (0.03-0.18)], >15 years of endoscopist experience [OR 0.24 (0.07-0.37)], IBD expertise [OR 2.86 (1.86-4.41)] and compliance of quality elements of reporting [OR 2.48 (1.24-3.76)] were significantly associated with endoscopic score reporting. Conclusion We identified a low prevalence of endoscopic activity score reporting in IBD patients’ colonoscopies. This finding is associated with operator-dependent characteristics. Educational interventions can be introduced to increase adequate score reporting.
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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 | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 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".