Defining Fecal Calprotectin Cutoffs That Predict Endoscopic and Histologic Remission in Patients With Ulcerative Colitis
Bibliographic record
Abstract
BACKGROUND: Fecal calprotectin is a reliable surrogate marker for disease activity in ulcerative colitis. However, there are no consensus cutoff values for histoendoscopic remission. This study aimed to correlate fecal calprotectin with Mayo endoscopic score and histological disease activity (Geboes score) for ulcerative colitis patients in clinical remission. METHODS: Prospective study including adult ulcerative colitis patients in clinical remission or disease relapse, undergoing endoscopy for disease activity or dysplasia surveillance at an inflammatory bowel disease center between 2013 and 2020. Fecal calprotectin was collected before bowel preparation and Mayo endoscopic score was documented during colonoscopy. Biopsies were taken throughout the colon and histological activity was assessed using Geboes score by a blinded expert gastrointestinal pathologist. RESULTS: Two hundred fifty-three patients were included, 117 (46%) were male (mean age of 38.2 years-standard deviation ± 24.8). A fecal calprotectin ≥ 123 μg/g predicts Mayo endoscopic score > 0 (58% sensitivity and 70% specificity), also aiding to differentiate Mayo endoscopic score 0 from 1 (61% sensitivity and 70% specificity). A fecal calprotectin ≥ 80 μg/g identified histological disease activity using Geboes score > 3.1 in patients with clinical remission (64.7% sensitivity, 58.7% specificity). Using Geboes score > 2, a fecal calprotectin ≥ 50 μg/g, is the most clinically relevant to identify patients in clinical remission with active histologic inflammation (49.6% sensitivity, 41.6% specificity). CONCLUSIONS: Fecal calprotectin correlates with endoscopic and histologic disease activity and can be used as a surrogate marker for disease activity. Our study prospectively demonstrated optimal cutoff values to discriminate histoendoscopic remission.
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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) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 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".