A262 THE EXCESS USE OF PROTON-PUMP INHIBITORS IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE
Bibliographic record
Abstract
Abstract Background Proton-pump inhibitors (PPI) use can impact the gut microbiome, thus, it is possible that use in children may be associated with an increase in pediatric IBD. Aims We investigated the common gastrointestinal symptoms that result in a PPI prescription in pediatrics prior to a diagnosis of IBD and the degree to which children with IBD use excess PPIs compared to controls either prior to or post a diagnosis of IBD. Methods The University of Manitoba IBD Epidemiology Database includes all Manitobans diagnosed with IBD 1984-2018 with age, sex, and geographic-matched controls. PPI prescription data were assessed from April 1995 onwards in children diagnosed with IBD prior to age 18. Results PPI were dispensed prior to IBD diagnosis in 9% of 614 children diagnosed with IBD and 0.8% of 5718 controls (P ampersand:003C0.0001) with the median age being 15 years. Children with Crohn’s disease were no more likely to have been PPI-users pre-diagnosis (10%) than persons with ulcerative colitis (8%, p=0.57). Relative PPI use increases within 1-year of an IBD diagnosis (rate ratio, RR=22.4 (95% CI 13.6-37); P ampersand:003C 0.001) compared with 3-5 years pre-IBD (RR=4.9, 95% CI 1.4-16.7) and 1-3-year pre-IBD (RR=2.5, 95% CI 1.01-6.2). The percent of children being prescribed a PPI increased the more they visited a physician, which was associated with increased likelihood of being prescribed a PPI. PPI use was similar for the various gastrointestinal diagnoses in cases of IBD and controls. PPI users prior to a diagnosis may have less severe disease than non-PPI users. We found they were less likely to be hospitalized (HR 0.36, 95% CI 0.19 – 0.68; P = 0.002). There was no difference among children who had surgery for their IBD whether they were PPI users prior to IBD diagnosis compared to non-users. Conclusions PPI use was commonly prescribed for a variety of gastrointestinal complaints, similarly in cases and controls. Children with IBD have many more contacts for gastrointestinal diagnoses than controls even for 5 years prior to their diagnosis. This raises the possibility that PPIs are prescribed indiscriminately for gastrointestinal complaints since their use was not restricted to complaints warranting PPI use, or that PPIs are prescribed for early symptoms that are secondary to IBD. Funding Agencies None
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".