Surveillance colonoscopy in patients with quiescent inflammatory bowel disease is associated with increased post-procedure steroid prescriptions: a national database study
Bibliographic record
Abstract
Abstract Surveillance colonoscopy reduces colorectal cancer (CRC) risk in inflammatory bowel disease (IBD), but anecdotal evidence suggests a link between surveillance colonoscopy and symptoms flare, which may affect patient compliance with CRC surveillance. We investigated the effects of surveillance colonoscopy in quiescent IBD using a national database to conduct a retrospective, propensity score-matched (PSM) cohort study of 1,717 patients with IBD and 1,717 patients without IBD who underwent colonoscopy. Strict inclusion criteria were used to select patients with quiescent IBD undergoing surveillance colonoscopy. We demonstrated that patients with quiescent IBD prior to colonoscopy received significantly more post-colonoscopy steroid prescriptions compared to matched controls (OR 1.46 [1.20, 1.77], p<0.001). Steroid prescriptions were more likely in patients with IBD at longer follow-up intervals, suggesting a delayed mechanism of onset for post-colonoscopy inflammation. No significant differences between groups were observed for the other outcomes of post-procedure emergency room and hospital visits or enteric infections. Our results suggest a potential risk of symptom exacerbation, evidenced by increased steroid prescriptions, following surveillance colonoscopy. Given that nearly 25% of patients with IBD do not receive surveillance colonoscopy at the recommended intervals, active post-procedure symptoms may be a contributing factor that warrants further investigation.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".