Fecal Calprotectin as a Biomarker for Disease Activity in Microscopic Colitis
Bibliographic record
Abstract
BACKGROUND: Microscopic colitis (MC) is an intestinal inflammatory disorder. An objective biomarker to assess ongoing disease activity has not been previously examined. We aimed to examine the utility of fecal calprotectin (FC) measurement in symptomatic individuals with microscopic colitis. METHODS: This cohort study included patients with a confirmed diagnosis of MC who had a calprotectin level measured in the setting of ongoing symptoms. We examined the frequency of elevation of FC in the setting of symptomatic microscopic colitis. Univariate and multivariate logistic regression models examined the independent predictors of elevated FC levels. RESULTS: Our study included a total of 166 subjects, yielding 234 independent instances of FC measurement during symptomatic MC. Of all 234 FC measurements, 68 (29.0%) levels were >150 mcg/g and 43 (18.4%) FC level>250 mcg/g. Those with elevated FC levels>150 mcg/g were older than those below this cutoff (54.7 vs. 61.5 y, P=0.011, respectively). A higher fraction of those with elevated FC (> 150 mcg/g) had nocturnal bowel movements (41.2 vs. 24.1%, P=0.009) and fecal incontinence (25.0 vs. 13.3%, P=0.029) compared with those with normal FC levels. This association was further evidenced on multivariate analysis. There was no difference in FC levels between those who were responsive or refractory to steroids (138 mcg/g vs. 249 mcg/g, P=0.45). CONCLUSIONS: Elevated calprotectin concentrations were noted in over a quarter of patients with symptomatic microscopic colitis and were associated with more severe symptoms. However, FC levels did not indicate the likelihood of treatment response.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.001 | 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".