Gaps between European Crohn’s Colitis Organisation quality standards of care and the real world on structure of IBD units across Europe: results from E-QUALITY survey
Bibliographic record
Abstract
BACKGROUND AND AIMS: Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, require an interdisciplinary approach for diagnosis, monitoring, and management. The European Crohn's and Colitis Organisation (ECCO) has developed evidence-based recommendations and quality care standards for IBD management, but gaps between these standards and real-world practice persist. The E-QUALITY task force aimed to evaluate the structure, processes, and outcomes of IBD units across Europe and identify barriers to achieving ECCO quality standards. METHODS: A web-based survey was conducted from September 2022 to October 2024 among 245 institutions in 35 European countries. The survey assessed unit structure, interdisciplinary care, services, facilities, and barriers to achieving quality care standards. Subgroup analyses were performed based on institution type, patient volume, and geographical distribution. RESULTS: Formal IBD units were present in 68% of institutions, with interdisciplinary teams available in 94%. Institutions with >500 active patients were more likely to meet ECCO standards for interdisciplinary care, quality indicators, and patient support but faced challenges such as lack of time and referral pathways. Geographical disparities significantly influenced the availability of resources and services. Key barriers to quality care included lack of time (71%), personnel (69%), and funding (45%). CONCLUSIONS: Significant gaps in quality care standards remain across European IBD units. Enhanced support from ECCO, by education and position papers/guidelines may help bridge these gaps.
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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 | 0.025 | 0.055 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.006 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| 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".