S1497 Clinical Characteristics and Outcomes of Patients with Primary Biliary Cholangitis–Autoimmune Hepatitis Overlap Syndrome – A Multicentric Cohort Study
Bibliographic record
Abstract
Introduction: Autoimmune hepatitis (AIH) and Primary Biliary Cholangitis (PBC) are the 2 main immune-mediated liver diseases. Occasionally, AIH can present with features of PBC. This overlap syndrome (OS) lacks standard diagnostic criteria and management strategies. “Paris criteria” (1998) is the most recognized diagnostic criteria for OS. The frequency of OS in literature has been reported between 7% and 13%. Our study will aim to evaluate the clinical characteristics and outcomes of OS patients in a multicentric Canadian cohort study. Methods: This cohort study included 198 patients originally diagnosed as OS in the Canadian Network for Autoimmune Liver Disease (CaNAL) registry which collects data from multiple tertiary centres across Canada. Available biochemical results and biopsy reports were reviewed and the diagnosis of OS for patients was reviewed based on Paris criteria (1998). Results: 57 patients (29%) did not have enough data to apply the criteria. 78 patients (55%) have met the Paris criteria for OS, of which 69 (88%) exhibited true OS on biopsy and 9 (12%) exhibited only AIH on biopsy. Sixty-three patients (45%) did not meet criteria for OS, with 22 (35%) exhibiting PBC on biopsy and 19 (30%) exhibiting AIH on biopsy. 16 patients (25%) showed OS on biopsy despite not meeting Paris criteria. Of those that met the Paris criteria for OS, the majority were female (88%) and 9 patients (12%) received liver transplant. Conclusion: Our results show that OS tend to be over-diagnosed which raises concerns that patients with PBC could be unnecessarily exposed to steroids as a result. In our cohort, OS patients exhibited female predominance. Further analysis of OS patients will be performed to determine clinical characteristics, outcomes of treatment, biochemical response, prognosis at 1 year, progression to cirrhosis and need for liver transplantation or death from liver failure. We will also compare outcomes to those diagnosed as either AIH or PBC in our cohort.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
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 | 0.001 | 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 | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| 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, unvalidatedLabeled directly by 2 models reading the full record.
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".