Clinical outcomes in pediatric inflammatory bowel disease patients: a systematic review of prospective studies
Bibliographic record
Abstract
Abstract Background and Aim We studied response and remission rates in children and adolescents with inflammatory bowel disease whose real‐world data were collected prospectively. Methods A systematic literature search was performed in MEDLINE, Embase, and the Improve Care Now registry from inception until March 17, 2022. Inclusion criteria were prospective studies with patients < 18 years at diagnosis (M0) and minimum follow‐up of 1 year (M12) mentioning disease phenotype and disease activity. Exclusion criteria were (i) reporting disease activity only at diagnosis, (ii) retrospective studies, and (iii) outcome limited to steroid‐free remission. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Protocols guidelines and the Newcastle‐Ottawa scale were applied. Proportions between groups were compared using a chi‐square test (α = 0.05). Results The search yielded 394 records and 7 inclusions with a sample size ranging from 33 to 390 patients (total population: 888) and a median follow‐up of 1–5 years. Proportions of disease activity differed between M0 and M12 (P < 0.0001) with more inactive (χ2 = 5.5) and less moderate‐to‐severe disease (χ2 = 23) at M12. Interestingly, disease activity after 1 year did not differ globally (P = 0.53). Proportions of disease activity in Crohn's disease only and limited to Belgium significantly differed from baseline after 5 years (P < 0.0001 for evolution) but not between 1‐ and 5‐year follow‐up (P = 0.94). Conclusions The few available prospective cohorts reported a significant decrease in disease activity after 1 year, with no global differences. Proportions of disease activity did not differ between 1‐ and 5‐year follow‐up in the Belgian Crohn's disease cohort, suggesting stable disease activity.
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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 | 0.013 | 0.048 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.010 |
| Bibliometrics | 0.012 | 0.014 |
| Science and technology studies | 0.001 | 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) | 0.003 | 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".