Clinical Outcomes Among Adolescents Diagnosed With Anorexia Nervosa During the <scp>COVID</scp>‐19 Pandemic
Bibliographic record
Abstract
OBJECTIVE: The COVID-19 pandemic was associated with a significant rise in the incidence of anorexia nervosa (AN) and atypical anorexia nervosa (AAN), longer wait times and reduced opportunities for in-person medical services. How these changes affected clinical outcomes among adolescents newly diagnosed with AN/AAN remains largely unknown. METHODS: We performed a retrospective analysis of standardized intake and follow-up data from a pediatric eating disorder program to compare clinical outcomes among adolescents newly diagnosed with AN/AAN during pre-pandemic (July/2017-December/2018) and pandemic (July/2020-December/2021) periods. Clinical data were collected at the time of diagnosis and at 1-, 3-, 6-, and 12-month intervals. The primary outcomes were unscheduled AN/AAN-related emergency department visits and need for medical hospitalization. RESULTS: Overall, 253 patients were included (pre-pandemic = 77; pandemic = 176). By 12-months following diagnosis, 18.8% (95% CI 13.3%-25.3%) of patients diagnosed during the pandemic had unscheduled AN/AAN-related emergency department visits, compared to 7.8% (95% CI 2.9%-16.2%, p = 0.03) of those diagnosed pre-pandemic. Medical hospitalization was required more frequently in the pandemic group (35.8%; 95% CI 28.7%-43.4%) compared to pre-pandemic (15.6%; 95% CI 8.3%-25.6%, p = 0.001). Mean weight gain at 12-months did not differ between groups (8.1 kg pre-pandemic vs. 8.8 kg pandemic; p = 0.35) however the mean time to target weight was longer in the pandemic group (2.7 vs. 4.4 months; p = 0.002). CONCLUSION: Patients newly diagnosed with AN/AAN during the pandemic had significantly more AN/AAN-related emergency department visits and hospitalizations and took longer to achieve target weight than those diagnosed pre-pandemic. These findings suggest a more complicated treatment course among adolescents diagnosed with AN/AAN during the pandemic.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
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 | 0.001 |
| 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, unvalidatedLabeled directly by 2 models reading the full record.
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".