Medication Withdrawal With Normal or Near-normal Histology in Ulcerative Colitis is Associated With Clinical Relapse
Bibliographic record
Abstract
GOALS: We sought to understand the clinical course and risk of dysplasia in persons with UC who achieve near or complete normalization of histology. BACKGROUND: Histologic remission and normalization in ulcerative colitis (UC) is associated with improved clinical outcomes. We sought to understand the clinical course and risk of dysplasia in persons with UC who achieve near or complete normalization of histology. STUDY: We performed a retrospective single-centred study of persons with UC who were in endoscopic remission with normal histology. Pathology slides were reread by a gastrointestinal-expert pathologist and both right and left colon were scored using the Geboes score. The primary outcome was time to clinical relapse, with secondary outcomes including episodes of dysplasia and colectomy. RESULTS: Seventy-eight persons had normal histology reported, although only 2 had completely normal histology on expert review. Approximately one-fifth of persons developed a clinical relapse at a mean of 4.7 years. Neither right nor left-sided colon histology was predictive of future clinical relapse. Forty-three percent of those who withdrew their IBD-therapy had a future clinical relapse, and were more likely to relapse than those who did not withdraw therapy (HR: 4.89, 95% CI: 1.32-18.08). There were zero episodes of dysplasia in follow-up, and 2 persons who relapsed ended up receiving a colectomy. CONCLUSIONS: Persons with UC who achieve normal or near-normal histology have moderate rates of clinical relapse. Physicians should be cautious when considering withdrawing IBD-therapy as this was associated with an increased risk of clinical relapse.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".