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S57 Clinical Profile of Patients With Inflammatory Bowel Disease in Brazil: Analysis of the National Registry (GEDIIB)

2023· article· en· W4389743725 on OpenAlexaboutno aff
Adriana Ribas Andrade, Lígia Yukie Sassaki, M. L. F. Farias, José Miguel Luz Parente, Gilmara Pandolfo Zabot, Pedro G. Pertence, Gabriela de Andrade Meireles Bezerra, Camila Chiqueti, João Feldman, Abel Botelho Quaresma, Rogério Serafim Parra, Omar Féres, Carlos Henrique dos Santos, Neogélia Almeida, Flora Lorenzo Fortes, Jaciane Araújo Mota Fontes, Genoile Oliveira Santana, Maria Clara P. Lopes, Valeria Salgado, Bernardo Carvalho, Mauro Bafutto, Sílvia Ribeiro Santos Araújo, Rafael Luís Luporini, Heitor Siffert Pereira de Souza, Fabio Luiz Maximiano, Giedre Herrerias, Rogério Saad-Hossne, Renata de Sá Brito Fróes, Cristina Flores

Bibliographic record

VenueThe American Journal of Gastroenterology · 2023
Typearticle
Languageen
FieldBiochemistry, Genetics and Molecular Biology
TopicInflammatory Bowel Disease
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineHematocheziaInflammatory bowel diseaseUlcerative colitisDiarrheaInternal medicineCohortDiseaseAbdominal painMedical recordCrohn's diseaseColonoscopyColorectal cancerCancer

Abstract

fetched live from OpenAlex

Background: In response to the rising prevalence of inflammatory bowel disease (IBD) in Brazil, which now exceeds 100 cases per 100,000 inhabitants, the Brazilian Crohn’s Disease and Colitis Organization (GEDIIB) established a National Registry of Patients with IBD to gather information about these conditions. This study presents a comprehensive analysis, encompassing all five geographic regions of the country (North, Northeast, Center-West, Southeast, and South), based on data collected over a span of three years. Methods: A cohort study was conducted from August 2020 to August 2023. The data were sourced from medical records and patient consultations using the REDCap platform, with approvals obtained from the ethics boards of participating institutions. Results: The study comprised 2,831 patients, with 47% diagnosed with ulcerative colitis (UC) and 51.1% with Crohn’s disease (CD). Sixty-two percent were followed in public centers, and 38% in the private system. The average age at diagnosis was 38 ± 15.5 years for UC and 33.7 ± 14.9 years for CD. Females predominated, constituting 64.5% of UC cases and 53.4% of CD cases. The majority of patients were of Caucasian descent (58.4% for UC, 63.7% for CD), followed by mixed-race individuals (32.3% for UC, 29.1% for CD) and Black individuals (8.8% for UC, 6.6% for CD). The most prevalent initial symptoms included abdominal pain, diarrhea, and weight loss, with CD patients experiencing them more frequently. Bleeding, such as enterorrhagia and hematochezia, was more common in UC. On average, diagnosis occurred approximately three years after the onset of symptoms. The Montreal CD classification revealed a predominance of A2 (58.8%), L3 (38.2%), and B1 (38.9%), with 19.3% perianal involvement. UC exhibited pancolitis (43.5%), left colitis (28.8%), and proctitis (27.7%). Notable oncologic comorbidities included colorectal and breast cancer, with 75% of colorectal cancers occurring in UC patients. Malnutrition affected only 3.9% of UC patients and 8.1% of CD patients, while overweight/obesity were alarmingly more prevalent (32% for UC, 18% for CD, and 27% for UC, 17% for CD, respectively). Among the extraintestinal manifestations, the most observed were rheumatological (19.4% for UC, 19.3% for CD), dermatological (5% for UC, 6.8% for CD), and hepatobiliary (3.8% for UC, 1.2% for CD). Comparing the data to previous years, the use of biological therapy, particularly infliximab, increased, while the use of 5-aminosalicylates (5-ASA) decreased in CD cases. Corticosteroid use was common at the time of diagnosis, affecting 50% of IBD patients. In the case of CD, there was a higher occurrence of urgent surgeries (40.8% vs 31%), resulting in 187 ostomies. Considering the surgeries of all IBD patients, 45% were open, and 10% were laparoscopic. Only 14 patients in the cohort died. Conclusions: The GEDIIB National Registry offers valuable insights into the profile of IBD in Brazil. Severe cases persist, and there is a growing trend in the use of biological therapy. The decline in 5-ASA use in CD cases suggests that increased medical education is promoting a more judicious use of medications, avoiding ineffective treatments that may delay the therapeutic window of opportunity and lead to greater complications.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.005
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.019
Threshold uncertainty score0.038

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.005
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0020.002
Science and technology studies0.0000.000
Scholarly communication0.0010.000
Open science0.0000.001
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0020.000

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.

Opus teacher head0.007
GPT teacher head0.270
Teacher spread0.263 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

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Citations0
Published2023
Admission routes1
Has abstractyes

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