DOP63 Time Trends of Environmental and Socio-economical Factors in Patients with Inflammatory Bowel Disease over 40-year of Different Therapeutic Eras; results from a Population-based Cohort from Western Hungarian between 1977-2020, The Hygiene hypothesis revisited.
Bibliographic record
Abstract
Abstract Background Data from population-based studies investigating the time trends in environmental and socio-economical factors associated with IBD is lacking. We aimed to assess time trends in environmental and socio-economical factors over 40 years of different therapeutic eras in patients with IBD from a prospective population-based inception cohort from Veszprem County, Western Hungary. Methods Patients from the incident IBD cohort were included between January 1,1977 and December 31,2020. Environmental and socio-economical factors, including an area of living, educational and type of employment, smoking status, appendectomy, and contraceptive drug use, were evaluated in three eras based on the different therapeutic strategies in IBD:cohort-A, 1977-1995 (pre-biologic/pre-immunomodulators era); cohort-B,1996-2008 (immunomodulator era); and cohort-C,2009-2020 (biological era). Results A total of 2,240 incident patients diagnosed with IBD were included [UC 61.2%, male 51.2%, the median age at diagnosis: 35 years (IQR 29-49)]. There was a significant increase in IBD incidence over time in both CD and UC1-2. A higher proportion of patients with active smoking in CD compared to UC, and the rates of smoking significantly decreased over time in CD; 60.2%, 49.9%, and 38.6% in cohorts A, B and C (p<0.001). In UC patients, the rates were lower and stable; 15.4%, 15.4%, and 14.5% in cohort A,B and C, respectively (p=0.981). The use of the contraceptive drug was more common in CD than UC, and the rates were stable; 23.7%,26.6%, and 23.7% in cohorts A, B and C (p=0.950). In UC patients, the appendectomy rates before diagnosis decreased over time; 6.4%, 5.5%, and 2.3% in cohorts A, B and C (p=0.013). No significant changes in the distribution of IBD population between geographic areas [municipal area: UC; 59.8%/64.8%/62.5% (p=0.309) vs. CD; 62.5%/62.0%/59.0% (p=0.636), in cohort A/B/C]. However, fewer percentages of IBD patients who achieved primary school as maximal education level (32.2%,21.9% and 11.7% in cohorts A,B, and C, p <0.001) as well as less physical work employment (53.4%,51.3%, and 42.3% in cohorts A,B and C, p=0.001) were observed in both UC and CD. (Reference 1.Gonczi L et al. Colitis. 2022 Sep 10:jjac132 Ref 2. Kurti Z et al. Crohns Colitis. 2022 Sep 19:jjac142) Conclusion This is one of the first long-term, prospective population-based cohorts investigating the time trends of socio-economical and environmental factors associated with IBD over 4 decades, including less primary school as maximal education level and less physical work employment. Results from this study highlight that the association between time trends of known environmental/socio-economic factors and IBD incidence is complex.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| 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) | 0.001 | 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".