Modificação do comportamento da doneça de Crohn baseada na classificação de Montreal, em centro de referência brasileiro para tratamento de doenças intestinais, no período de 20 anos de acompanhamento
Bibliographic record
Abstract
Crohns Disease (CD) is a chronic recurrent inflammatory condition of the gastrointestinal tract which can present with different phenotypes throughout its clinical course. It is believed that the inflammatory behavior is the initial presentation, which can evolve with time into a more complex disease, with stricturing or penetrating patterns. The aim of the study was to evaluate the behavior of CD over twenty years in a brazillian referral center for intestinal diseases and to assess the predictors of developing complications. One hundred and seventy patients with CD who fulfilled all the criteria were selected by retrospective analysis of medical records and were stratified according to the Montreal Classification at diagnosis and after 1, 3, 5, 10, 15 and 20 years of follow-up. Patients who had inflammatory behavior at diagnosis were included in the longitudinal retrospective study and assessed for the risk of developing complications using the Kaplan-Meier method. Variables such as gender, smoking, age of 40 or under, disease location, steroid dependence, early immunosuppression, biologic therapy and early surgery were analyzed as predictors of complications. At the time of diagnosis, 62.94% of the patients showed the inflammatory behavior, 22.35% had the stricturing pattern and 14.71% had penetrating disease. After ten years, 38.89% had maintained the inflammatory pattern and 61.11% had evolved to complications. The disease location, however, rema ined stable during the same period. After a medium follow-up of 7 years, 22.74% patients with inflammatory behavior at diagnosis developed stenosis or fistulas. Steroid dependence was the only predictor of the occurrence of complications. Our study allowed to conclude that more than 50% of the patients with CD evolve to strictur ing and/or penetrating behavior after 10 years of disease, but the disease location remains stable. The likelihood of developing complications is almost 20% after five years of diagnosis. Steroid dependence is a risk factor for developing complications.
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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 | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| 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".