Which endoscopic severity assessment tool correlates best with non-invasive Crohn’s disease activity parameters?
Bibliographic record
Abstract
Aims Although there are several scores for endoscopic severity assessment in Crohn’s disease (CD), there is conflicting and scarce information regarding their agreement and relationship with laboratory non-invasive parameters, namely C-reactive protein (CRP) and fecal calprotectin (FC). We aimed to investigate the agreement between the Simple Endoscopic Score for Crohn’s Disease (SES-CD), Modified Multiplier SES-CD (MM-SES-CD), and the recently suggested Toronto Inflammatory Bowel Disease Global Endoscopic Reporting (TIGER) score and their correlation with CRP and FC in CD. Methods Retrospective cohort-study including all ileocolonoscopies performed in adult CD patients between January 2021 and July 2023 with CRP (mg/dL) and FC (ug/g) collected within one month. Patients with previous intestinal surgery or inadequate bowel preparation were excluded. Agreement between SES-CD (active disease>3), MM-SES-CD (active disease≥14), and TIGER scores (active disease≥100) was determined using Kappa statistics (k) and each value was correlated with laboratorial biomarkers using Spearman's correlation coefficients (rho). Results A total of 312 ileocolonoscopies from 246 CD patients were included, most females (52.9%) with a mean age of 42±14 years old. According to Montreal Classification, most patients had A2 (71.2%), L1 (47.8%) and B1 (69.6%) disease. Median SES-CD, MM-SES-CD, TIGER scores were 3, 12, and 3 points, respectively. The mean/median value of CRP was 2.9 mg/dL, while mean FC value was 243 ug/g. There was an excellent, strong, and moderate agreement between SES-CD and MM-SES-CD (k=0.929, P<0.001), SES-CD and TIGER (k=0.682, P<0.001), and MM-SES-CD and TIGER score (k=0.504, P<0.001), respectively. There was a fair correlation between SES-CD (rho=0.412), MM-SES-CD (rho=0.423), TIGER score (rho=0.430) and CRP (P<0.001). SES-CD (rho=0.563), MM-SES-CD (rho=0.540) had a fair correlation and TIGER score (rho=0.610) had a moderate correlation with FC (P<0.001). Conclusions Although existing Crohn’s disease endoscopic severity scores have moderate to strong agreement regarding endoscopic activity, they continue to have suboptimal correlation with laboratory non-invasive biomarkers. Publication History Article published online: 15 April 2024 © 2024. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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 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 | 0.004 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 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 | 0.001 |
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".