P0485 Seroproteomic index of endoscopic activity associates with endoscopic outcomes in a longitudinal cohort of adults ulcerative colitis
Bibliographic record
Abstract
Abstract Background A seroproteomic index of endoscopic activity (serum index) is validated in adult CD but its performance in Ulcerative Colitis (UC) is lacking. We prospectively evaluated the serum index in an observational cohort of adult UC undergoing longitudinal endoscopic assessments. Methods UC underwent Montreal classification, were consented and followed longitudinally for their outcomes (clinical and endoscopic) at a single center. Serum specimens were collected at the time of assessments. The UC endoscopic index score (UCEIS) was calculated, with scores above 4 points indicating endoscopic active disease. Clinical symptoms were measured using the partial Mayo score with score < 2 points indicating clinical remission. The serum index which is a composite of CRP-HS plus 12 other proteins in an algorithm that associates with endoscopic outcomes in CD was applied unmodified in UC. The index ranges from 0 to 100 points where higher index are associated with higher likelihood of endoscopic active disease. All sera were processed by an accredited clinical laboratory. Receiver operating characteristic curves (ROC with area under the curve [AUC]) and logistic regression were employed to evaluate the index in distinguishing endoscopic outcomes. Nonlinear mixed effect models were used to correlate the longitudinal changes in UCEIS (>1 endoscopic assessment). Results A total of 231 patients with UC (mean age 41 years, n=115 females) were enrolled, and 294 serum samples with an UCEIS score were collected. Average partial Mayo score was 2.5±2.7 points [SD] with 50% assessments in clinical remission. Average UCEIS was 2.2±2.3 points (22% [n=66] with UCEIS>4 points). Average CRP, and serum index was 5.2±8.1 mg/L, and 38±19 points, respectively. Comparison in distinguishing UCEIS>4 points yielded significantly higher AUC with serum index (AUC=0.797±0.034) than with CRP (AUC=0.714±0.035) (p=0.047). In subjects with more than one endoscopic assessment (n=49/112 endoscopies), the change in partial Mayo scores, CRP and serum index associated with the changes in the UCEIS (Table). At optimal cutoff, serum index above 42 points yielded 73% sensitivity and 78% specificity in identifying moderate to severe endoscopic disease (OR= 9.0 95%CI: 5.0-17.2) (p<0.001) (PPV=52%, NPV=89% with 25% pretest probability). In multivariate analysis, endoscopic active disease associated with the absence of clinical remission (aOR=0.05 (95%CI: 0.01,0.16) with each point increase in serum index yielding 1.05 (95%CI: 1.03,1.07) fold higher likelihood of endoscopic active disease (Figure). Conclusion We have validated the performance of a seroproteomic index of endoscopic activity in adults with UC demonstrating its potential as a non-invasive biomarker.
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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 | 0.002 |
| 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".