Psychological well-being is the major determinant of global health in the first year following a diagnosis of inflammatory bowel disease in children
Bibliographic record
Abstract
Inflammatory bowel disease (IBD) represents a group of disorders with no known cure. IBD is impacted by biopsychosocial factors. The burden, psychosocial difficulties, and gene-environment interaction involved in the manifestation of IBD necessitate a fuller understanding of factors which worsen or ameliorate IBD. Case complexity (CC) captures current and historical biopsychosocial risks for individuals with IBD and holds promise for understanding variation in treatment response and individuals' experiences with IBD. The present study aimed to understand the relative contributions of: 1) historical vs. current factors impacting CC in predicting global health; and 2) biological, psychological, social, family, and health system factors on global health. Within a longitudinal design, 8–17-year-old youth ( N = 83) completed the self-report Pediatric Global Health 7 + 2 at diagnosis (baseline) and 4- and 12 months post-diagnosis. The p-IBD-INTERMED, a clinical-decision support tool, which standardizes inter-professional assessment of biopsychosocial risks contributing to CC was completed by the healthcare provider team at the same timepoints. CC was associated with global health at all time points (T1 r = −0.27; T2 r = −0.42; T3 r = −0.50). Hierarchical regression revealed that across time the relative contribution of historical CC was surpassed by current CC when predicting global health (at T1 β HCC= -0.13 ; β CCC = −0.17; at T3 β HCC = -0.04; β CCC = −0.48). In this cohort, at 4- and 12-months post diagnosis, psychological factors were the only domain of current CC to significantly predict global health, accounting for 29.1 % and 24.1 % of its variance respectively. Findings suggest that the global health of patients with IBD is not fixed by early life experiences. Background Inflammatory bowel disease (IBD) represents a prevalent group of disorders with no known cure. IBD is impacted by myriad biopsychosocial factors. The pervasive burden, pronounced psychosocial difficulties, and the potential gene-environment interaction involved in the manifestation of IBD necessitate a fuller understanding of factors which might worsen or ameliorate IBD. Case complexity (CC) captures current and historical biopsychosocial risks for individuals with IBD and holds promise for understanding variation in treatment response and individuals' experiences with this chronic illness. Aims We sought to understand the relative contributions of: 1) historical vs. current factors impacting CC in predicting global health (self-reported); and 2) biological, psychological, social, family, and health system factors on global health. Methods Within a longitudinal design, 8–17-year-old youth ( N = 83) completed the self-report Pediatric Global Health 7 + 2 at diagnosis (baseline) and 4- and 12 months post-diagnosis. The p-IBD-INTERMED, an interview-based measure of CC, was completed by the healthcare provider team at the same timepoints. Results CC was associated with global health at all time points (T1 r = −0.27; T2 r = −0.42 ; T3 r = −0.50). Hierarchical regression revealed that across time points the relative contribution of historical CC was surpassed by current CC when predicting global health (at T1 β HCC= − 0.13 ; β CCC= − 0.17 ; at T3 β HCC= − 0.04 ; β CCC= − 0.48). In this cohort of newly diagnosed children that had good medical response by one-year post diagnosis, at 4- and 12-months post diagnosis, psychological factors were the only domain of current CC to significantly predict global health, accounting for 29.1 % and 24.1 % of its variance respectively. Discussion Findings suggest that the global health of IBD patients is not fixed by early life experiences and shed light onto potential psychosocial treatment targets.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.003 |
| 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".