Long-Term Disease Course of Crohn’s Disease in a Prospective European Population-Based Inception Cohort: An Epi-IBD Cohort Study
Bibliographic record
Abstract
BACKGROUND & AIMS: The Epi-IBD cohort is a population-based inception cohort of patients with inflammatory bowel disease from 22 European centers. The aim was to assess the 10-year disease course of patients with Crohn's disease (CD) and how regional differences in treatment strategies impact the disease course. METHODS: Patients were followed prospectively from the time of diagnosis, with uniform collection data. Associations between outcomes and covariates were analyzed by multivariable Cox regressions in a propensity score-matched sub-population to address time to first intestinal resection. RESULTS: A total of 547 patients with CD were recruited (Eastern Europe: 139 [25.4%]; Western Europe: 408 [74.6%]). Ten-year cumulative rate of advanced therapy use was higher in Western (42%) compared with Eastern Europe (27%) (P < .05). The median period until initiation of advanced treatment was shorter in Western Europe (10 vs 46 months; P < .001). Despite these differences, the need for surgery remained comparable in Eastern and Western Europe, with a 10-year rate of 24% (P = .9). A similar comparability was observed for disease progression from uncomplicated disease to complicated disease (10-year rate: 20%; P = .07) and hospitalization (10-year rate: 41%; P = .5). Use of advanced therapy, stricturing or penetrating disease at diagnosis, progression of disease behavior, and former smoking were all associated with an increased risk of intestinal resection (all P < .05). CONCLUSIONS: Despite earlier and more frequent use of advanced therapies in Western Europe, no differences in disease outcomes were observed between Western and Eastern European patients. Ten years after diagnosis, 1 in 5 patients with uncomplicated disease at diagnosis progressed to complicated disease, and 1 in 4 needed surgery.
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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) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".