A Triple Perspective on the Triple Visit: Protocol for a Mixed Methods Evaluation of the Implementation of a Pediatric Multidisciplinary Clinic Model for Inflammatory Bowel Disease
Bibliographic record
Abstract
BACKGROUND: Given the impact of inflammatory bowel disease (IBD) on both physical health and psychosocial functioning, the management of pediatric IBD requires a multidisciplinary approach that provides holistic care, rapid access, and health education to young patients with IBD. Yet despite recommendations, a formalized clinic model for holistic pediatric IBD care remains an unmet need for this population. OBJECTIVE: The objective of this study is to comprehensively evaluate the implementation of a new clinic model aimed at providing holistic care, rapid access, and health education for pediatric patients with IBD. METHODS: This study uses a multiperspective mixed methods design, incorporating both qualitative and quantitative data collected simultaneously from clinicians, parents or guardians, and pediatric patients. The quantitative component includes a pre-post implementation chart review, structured observations of clinical practices, and surveys tailored to pediatric patients and their parents or guardians. The qualitative aspect encompasses semistructured interviews with clinicians and parents or guardians as well as play-based interviews with patients. Triangulation will be used to converge these different methodologies and to produce a holistic evaluation of the IBD clinic. RESULTS: This study was approved by the Humber River Health Research Ethics Board on December 23, 2024. Recruitment for this study began on January 30, 2025, and we anticipate a data collection end date of December 2025. CONCLUSIONS: Given that this clinic model is relatively new, this protocol will provide sound methodological direction for other studies that aim to evaluate or implement this type of model in their setting. The evaluation itself will provide comprehensive insights into both the successes and challenges of implementing a multidisciplinary approach that provides a holistic model of care for pediatric patients with IBD. As such, this evaluation will be foundational in providing an applied understanding of the impact and effectiveness of this holistic approach in pediatric patients with IBD. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/72670.
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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 | 0.116 | 0.090 |
| Meta-epidemiology (narrow) | 0.004 | 0.004 |
| Meta-epidemiology (broad) | 0.005 | 0.004 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.006 | 0.003 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.005 | 0.004 |
| Research integrity | 0.006 | 0.008 |
| Insufficient payload (model declined to judge) | 0.060 | 0.012 |
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".