P771 Comparing obstructive symptoms and dietary restrictions with Crohn's disease stricture severity
Bibliographic record
Abstract
Abstract Background Stricturing Crohn’s Disease (CD) is characterized by bowel narrowing often leading to obstruction. Obstructive symptoms (OS) have been evaluated in patients with CD strictures using OS scores (STRIDENT). Clinical observations suggest that OS are generally associated with end-stage strictures requiring dietary restrictions and surgery. Evaluating the prevalence of symptoms in strictures is important as regulatory agencies require symptom response to therapies in trials. Intestinal ultrasound (IUS) accurately assesses CD strictures. IUS criteria for ileal strictures includes: 1) bowel wall thickness (BWT) > 3mm, 2) luminal narrowing, and 3) pre-stenotic dilation (PSD) > 2.5 cm. It remains unclear whether stricture severity is correlated with OS (nausea, vomiting, bloating, abdominal pain). We aim to assess if OS and dietary restrictions occur more often in those with more severe strictures (pre-stenotic dilation size). Methods In this pilot study, prospective ileal CD patients with inflammatory (non-stricture) phenotype versus definitive or probable strictures were surveyed. OS for the past 2 months were queried in patients with definitive (BWT >3mm, luminal narrowing < 1cm, PSD ≥ 2.5cm), and probable strictures (definitive with PSD < 2.5cm) as identified on IUS. OS queried included nausea, vomiting, bloating, abdominal pain, and dietary restrictions. Chi-squared tests for categorical symptoms and one-way ANOVA (Kruskal Wallis) was used to compare symptom prevalence within the non-stricture or stricture category. Results 39 patients were recruited with a median diagnosis age of 23.5 years (range 24-69) with 12 non-stricture phenotype (30.8%), 13 definitive (33.3%), and 14 probable stricture (35.9%). Patients with definitive strictures (35.3%) have significantly more nausea than those without strictures (11.8%) (p = 0.01), and no difference with probable strictures. Nausea with probable strictures (41.2%) was not significantly different from non-stricture patients (11.7%) (p = 0.07). In those with definitive versus non strictures, bloating (53.6 % vs 61.5 %, p = 0.69), post prandial pain (57.6 % vs 25.0 %, p = 0.14), and vomiting (10.0% vs. 20.0%, p = 0.47) were not significantly different. No difference was found in obstructive pain (F=2.27, p=0.12) among all groups. Dietary restrictions occurred in 40% (5/12) without strictures, 43.8% (7/12) with probable strictures, and 69.2% (9/13) with definitive strictures. Conclusion Nausea was the sole indicator distinguishing definitive from probable strictures. Pain, vomiting, and bloating did not differentiate those with severe from probable strictures, possibly due to dietary restrictions. More recruitment will refine these findings and enable comparison with specific IUS parameters.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".