S91 Association Between Small Bowel Lesion Activity and Fecal Calprotectin in Pediatric Crohn’s Disease
Bibliographic record
Abstract
Background: The widespread use of capsule endoscopy (CE) has allowed detailed evaluations of small bowel lesions in Crohn’s disease (CD). CE is a minimally invasive procedure commonly performed in children but often conducted in hospitals. Some patients have difficulty in swallowing, often requiring multiple endoscopies with capsule endoscopic assist devices. Therefore, CE cannot be performed easily on children. Markers that reflect the activity of small bowel lesions may help determine the necessity of endoscopic assessments. In adults, fecal calprotectin (Fc) is a useful marker for small bowel lesion activity. To date, its utility in children remains unexplored. This study retrospectively investigated whether Fc can effectively reflect the activity of small bowel lesions in pediatric CD by comparing it with other biomarkers. Methods: The study recruited children with CD, including those with suspected CD, who underwent CE at our hospital between January 2023 and August 2024. Patients with Montreal classifications of L1 and L3 were deemed eligible. Patients who had not undergone an Fc test within 3 months before or after CE, or who had undergone bowel resection were excluded. Mucosal healing was defined as a Lewis score (LS) < 135. Only children aged < 16 years were included. Results: Eighteen patients were analyzed; 15 (83%) were male. Nine patients had a confirmed diagnosis of CD, and 9 had a suspected diagnosis after examination. The median age at examination was 10 years (range 7-14 years). The median PCDAI was 5 points (range 0-42.5). The median LS was 135 (range 0-1200), and the median Fc was 788 mg/kg (range 0-7323 mg/kg). ROC-AUC analysis showed a strong correlation between Fc and LS at 0.86. The cut-off value for discriminating mucosal healing was 90.0 mg/kg (sensitivity, 66.7%; specificity, 100%). The AUCs of the other biomarkers correlated with white blood cells (0.57), hemoglobin (0.56), platelets (0.56), albumin (0.58), erythrocyte sedimentation rate (0.67), and CRP (0.75), all of which were lower than the AUC of Fc. Conclusions: Fc may be more useful than other biomarkers for assessing small bowel lesion activity in pediatric patients with CD.
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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 | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".