P449 Beyond a patient's control: assessing non-modifiable factors of transition readiness in IBD patients who have transferred to adult care
Bibliographic record
Abstract
Abstract Background The transition from paediatric to adult care is an important time for a patient diagnosed with inflammatory bowel disease (IBD) in childhood/adolescence. A systematic review by Johnson et al., identified non-modifiable and modifiable factors that impact transition readiness. This review summarized positive associations with non-modifiable factors, such as females had higher self-management scores than males, patients with Crohn’s disease or a family IBD history associated with higher self-efficacy scores. Older age at diagnosis was associated with lower self-management scores in one study. Lack of or conflicting associations were found with respect to medication type and age at diagnosis. We aim to assess the prevalence of these non-modifiable factors in our patient population at time of transfer to adult care. Methods We conducted a medical chart review of patients with IBD who had their first adult care appointment between 2015 and 2022 at an academic IBD clinic in Alberta, Canada. We recorded information on non-modifiable factors, including gender, diagnosis, age at diagnosis, family history of IBD, and IBD medication type at time of first adult appointment. We used descriptive statistics to summarize the non-modifiable factors in our patient population. Results We reviewed the medical charts of 198 patients. The median age of IBD diagnosis was 14.4 years old (IQR: 13.0-15.9) with 2.5% of patients were diagnosed between 0-4; 6.1% between 5-9; 51.0% between 10-14; 40.4% between 15-17. At time of first appointment in adult care, 29.5% were on biologic monotherapy; 28.3% were on biologic combination therapy; 33.3% were on either 5-ASA or an immunosuppressant; the remaining 9.1% were either not on any IBD medications or medications were not documented. 43% of patients were female gender; while 60.0% of patients had Crohn’s disease; 6.6% had IBD-U, and 33.3% had ulcerative colitis. Further, 13.6% of patients had a first degree relative with IBD. Conclusion This study reports the prevalence of non-modifiable factors associated with transition readiness. By identifying these factors, we can direct more resources towards supporting specific populations in achieving transition readiness. For example, our study found that only 13.6% had a first degree relative with IBD – a factor positively associated with self-efficacy. This represents a large population without a relative with IBD that could benefit from resources designed to improve self-efficacy. Overall, this study supports future research aimed at designing interventions to improve readiness tailored to patients who may benefit the most.
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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 | 0.003 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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, 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".