A132 PREDICTIVE VALUE OF ENDOSCOPIC EVALUATION IN EOSINOPHILIC ESOPHAGITIS
Bibliographic record
Abstract
Abstract Background Clinical trials for eosinophilic esophagitis (EoE) currently use the peak eosinophil count (PEC) and patient-reported outcomes as coprimary endpoints for determining therapeutic efficacy. Although the PEC reflects histological activity in EoE, it has not been consistently correlated with symptoms nor endoscopic appearance and the prognostic value of endoscopy relative to the PEC is unclear. Aims We evaluated the Endoscopic Reference Score for EoE (EREFS) as a predictor of clinically relevant endpoints. Methods We evaluated a retrospective prevalent cohort of adults (>18) with EoE undergoing upper endoscopy between 2010 and 2023 from two tertiary care institutions. The EREFS total score, individual components, inflammatory and fibrostenotic subscores were assessed. The primary endpoint was a composite outcome of food bolus impaction (FBI), requirement for esophageal dilation, and hospitalization for EoE within 12 months of the baseline endoscopy. Logistic regression was used to assess the association between EREFS and the composite endpoint. Results A total of 350 patients were included (225 [64.3%] male, mean age at presentation 35.0 years [SD 13.6], 299 [85.4%] presenting with predominantly dysphagia). Mean EREFS at baseline was 4.3 (SD 1.8), with a mean inflammatory subscore of 2.3 (SD 1.3) and fibrostenotic subscore of 2.0 (SD 1.0). Most patients had a baseline stricture (269/350, 76.9%) and 135 (38.6%) underwent dilation at baseline to a mean diameter of 14.3 mm (SD 2.4). The mean baseline PEC was 44.3 eos/HPF (SD 35.1). Baseline EREFS was significantly associated with the composite primary outcome (OR 1.32 [95% CI: 1.16, 1.50], p<0.001) whereas the PEC was not associated (OR 1.03 [95% CI: 0.97, 1.10], p=0.30 for each 10 eos/HPF increase). The baseline fibrostenotic EREFS (OR 2.04 [95% CI: 1.58, 2.64], p<0.001) and presence of stricture (OR 6.12 [95% CI: 3.28, 11.43], p<0.001) were significantly associated with the composite primary endpoint, even when patients with baseline dilation were excluded. Conclusions The fibrostenotic EREFS subscore is significantly associated with the requirement for future dilation and food bolus impaction, with prognostic value beyond that of the PEC alone. Funding Agencies None
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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 | 0.010 |
| 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 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".