P444 Active perianal Crohn’s disease negatively impacts patients’ quality of life, psychosocial wellbeing and is associated with barriers related to social determinants of health
Bibliographic record
Abstract
Abstract Background Perianal fistulizing Crohn’s Disease (PFCD) is associated with poor quality of life (QoL) and increased healthcare utilization. However, the effect of PFCD on patients’ lives remain incompletely understood. We conducted a survey-based study of patients with PFCD to examine the impact of perianal fistula disease activity on QOL, psychosocial wellbeing, and barriers related to SDOH. Methods Patients aged 18 years and above with a diagnosis of PFCD were included between July and November 2023 at Mount Sinai Hospital. Patient data, including demographics and clinical data, were obtained from patients and chart review. Perianal disease classifications were assessed through chart review. Crohn’s anal fistula quality of life (CAFQOL) scale, PROMIS scale for anxiety and depression, Internalised stigma for mental illness (ISMI), Everyday discrimination scale, health first screening tool for SDOH and the Cantril ladder of life scale were administered to patients. Patients with active PFCD, defined as perianal pain and/or drainage, were compared to patients with inactive PFCD, defined as lack of perianal pain or drainage. Descriptive statistical analysis was performed using SPSS Results A total of 50 patients were included in the study, of whom 39 had active disease and 11 inactive disease (Table 1). Annual household income was lower among patients with active PFCD (p=0.017). Disease characteristics such as Montreal classification, HBI and perianal disease classification, presence of proctitis, surgical history were similar across both groups. Overall, patients with active PFCD compared to inactive PFCD had higher CAFQOL scores (mean active:inactive;1.82:0.44, p<0.001). Patients with active PFCD also had higher rates of depression and anxiety (mean 2.06:1.23, p=0.020). Internalised stigma was higher among patients with active PFCD. There was no difference in discrimination faced as a consequence of PFCD. 20.5% and 12.8% patients with active PFCD reported facing social isolation and food insecurity respectively. By the Cantril ladder, patients with active PFCD had lower current life satisfaction compared to inactive PFCD (mean 6.03:7.60, p=0.024). However, there was no difference in their outlook on life satisfaction in 5 years. Conclusion In our cohort, perianal disease activity alone results in significantly worse quality of life and negatively impacts psychosocial wellbeing. Patients with active PFCD are at risk for barriers related to SDOH which are known to have implications on health equity.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 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".