Trends in Arthritis Prevalence Among Individuals with Inflammatory Bowel Disease: A Population-Based Study
Bibliographic record
Abstract
Objectives The burden of arthritis among individuals with inflammatory bowel disease (IBD) is poorly understood. We describe changes over time in the annual prevalence of inflammatory arthritis (IA) and musculoskeletal (MSK)-related physician encounters among individuals with IBD. Methods We conducted a retrospective repeated cross-sectional study using Ontario population-based health administrative data. We used the Ontario Crohn’s and Colitis Cohort which comprises all IBD patients derived from health administrative data using validated age-specific case-identification algorithms (highly accurate). Individuals diagnosed with IBD between April 01, 2003, and March 31, 2020 (population denominator) were followed from their first IBD code (index date) until they died or were lost to follow-up (out-migrated/lost health care coverage), or until the end of available follow-up data (March 31, 2020). We identified the cumulative prevalence of inflammatory arthritis (≥1 hospitalization/ED encounter or ≥2 physician billing claims with IA-related diagnosis codes with ≥1 by a rheumatologist within 365 days). Separately we identified the annual number of individuals with ≥1 hospitalization/ED encounter/physician billing claim with any non-trauma related MSK-specific diagnosis codes. The annual age- and sex-standardized cumulative prevalence of both IA and MSK among individuals living with IBD each year, were separately determined and stratified by age (≤18 yrs, 18-64 yrs, ≥65 yrs). Results Over the study period, the number of individuals living with IBD increased from 54,283 in 2003 to 108,857 in 2020; the number of children <18 yrs increased from 1,547 to 2,667. Among all ages, the age/sex-standardized cumulative IA prevalence within the IBD cohort increased from 6.8% (95% CI 6.5-7.2%) in 2003 to 15.2% (95% CI 15.0-15.8%) by 2020 (Figure 1). IA was slightly more common among those with Crohn’s than ulcerative colitis (17.4% vs 13.2%, respectively). By 2020, IA prevalence was 6.8% among children/youth <18 yrs, 17.4% among those 18-64 yrs, and 23.1% among those ≥65 yrs. Overall, crude annual prevalence of an MSK-related encounter remained relatively stable from 30.6% in 2003 to 27.7% in 2020. Figure 1. Annual prevalence of Inflammatory arthritis in prevalent inflammatory bowel disease cohort stratified by age group. Conclusion This study is the first to provide population-level estimates of IA and MSK-related conditions in people with IBD. The cumulative prevalence of IA among individuals with IBD has steadily increased over time, particularly among those ≥65years, while MSK-related encounters have not. This may be related to increased physician recognition of IA or increased access to care and diagnosis. These findings have implications for healthcare costs and utilization, given the specialized care and expertise required to manage IA in the context of complex, comorbid conditions like IBD.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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, 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".