European Journal of Gastroenterology & Hepatology最新文献_第7页

Clinical and biochemical factors for bacteria in bile among patients with acute cholangitis. 急性胆管炎患者胆汁中细菌的临床和生化因素。

IF 2.1 4区医学

European Journal of Gastroenterology & Hepatology Pub Date : 2024-09-11 DOI: 10.1097/meg.0000000000002849

Jin Zhao,Bin Wang,Meidan Zhao,Xinling Pan

{"title":"Clinical and biochemical factors for bacteria in bile among patients with acute cholangitis.","authors":"Jin Zhao,Bin Wang,Meidan Zhao,Xinling Pan","doi":"10.1097/meg.0000000000002849","DOIUrl":"https://doi.org/10.1097/meg.0000000000002849","url":null,"abstract":"BACKGROUNDAcute cholangitis is a clinical syndrome caused by a bacterial infection in the biliary system. The bacteria could exist in the bile before bile drainage despite empirical antibiotic treatment.METHODSPatients with acute cholangitis admitted to a tertiary hospital in Southeastern China from August 2011 to September 2021 were involved when bile cultures were performed. Patient information before bile cultures and during hospitalization was extracted from the clinical record database. The risk factors related to bacteria in bile were assessed by univariable and multivairable logistic regression analysis, respectively.RESULTSA total of 533 patients (66.05%) had bacterial growth in bile. Alanine aminotransferase concentration [odds ratio (OR) = 0.998, P < 0.001], absolute monocyte count (OR = 0.335, P = 0.001), and duration of antibiotic use (OR = 0.933, P = 0.026) were negatively correlated with bacteria in bile. In contrast, C-reactive protein (OR = 1.006, P = 0.003), thrombin time (OR = 1.213, P = 0.033), prothrombin time (OR = 1.210, P = 0.011), and age (OR = 1.025, P < 0.001) were positively correlated with bacteria in bile. Based on an area under the receiver operating characteristic curve of 0.737 (95% CI, 0.697-0.776, P < 0.001), combining these seven variables could efficiently predict the presence of bacteria in bile among patients with acute cholangitis.CONCLUSIONThe combination of clinical indicators before bile drainage could predict the risk of bacteria in bile for patients with acute cholangitis.","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic model for spontaneous bacterial peritonitis in cirrhotic patients with ascites: a multicenter cohort study. 肝硬化腹水患者自发性细菌性腹膜炎的诊断模型：一项多中心队列研究。

IF 2.1 4区医学

European Journal of Gastroenterology & Hepatology Pub Date : 2024-09-11 DOI: 10.1097/meg.0000000000002841

Xuehong Yin,Enqiang Qin,Rui Song,Xuli Bao,Jinling Dong,Wei Hou,Wei Hua,Bo Tu,Yuening Zhang,Qinghua Meng

{"title":"Diagnostic model for spontaneous bacterial peritonitis in cirrhotic patients with ascites: a multicenter cohort study.","authors":"Xuehong Yin,Enqiang Qin,Rui Song,Xuli Bao,Jinling Dong,Wei Hou,Wei Hua,Bo Tu,Yuening Zhang,Qinghua Meng","doi":"10.1097/meg.0000000000002841","DOIUrl":"https://doi.org/10.1097/meg.0000000000002841","url":null,"abstract":"INTRODUCTIONSpontaneous bacterial peritonitis (SBP) is a potentially life-threatening complication of cirrhotic ascites. Early diagnosis and treatment of SBP are essential to improve the survival rates and prognosis of patients. We aimed to identify the predictors of SBP to establish a new noninvasive early diagnostic tool.METHODSWe screened 1618 patients who underwent paracentesis due to cirrhotic ascites between January 2017 and December 2018 in three hospitals. We evaluated the symptomatic, clinical, and laboratory parameters to identify the predictors of SBP. The primary diagnostic model was displayed as a nomogram.RESULTSThe model included abdominal pain, diarrhea, white blood cell count, neutrophil percentage, procalcitonin, C-reactive protein, lactate dehydrogenase, glucose, and Model for End-stage Liver Disease score. The model's diagnostic performance was good, with an AUC of 0.84 [95% confidence interval (CI), 0.81-0.87] in the training cohort. In the validation cohort, the diagnostic ability was also good, with AUCs of 0.87 (95% CI, 0.83-0.91) and 0.90 (95% CI, 0.87-0.94) for inner and outer validation queues, respectively. Moreover, the decision curve analysis confirmed the clinical utility of the nomogram model. In addition, we developed a Microsoft Excel calculation model to allow convenient adoption of the model in clinical practice.CONCLUSIONWe developed good performing diagnostic models for SBP.","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Entecavir vs. tenofovir disoproxil fumarate in the treatment of chronic hepatitis B patients with severe acute exacerbation. 恩替卡韦与富马酸替诺福韦酯在治疗严重急性恶化的慢性乙型肝炎患者中的对比。

IF 2.3 4区医学

European Journal of Gastroenterology & Hepatology Pub Date : 2024-09-01 Epub Date: 2024-06-26 DOI: 10.1097/MEG.0000000000002709

Chih-Yang Lin, Wei-Chih Sun, Chia-Ming Lu, Wen-Chi Chen, Feng-Woei Tsay, Tzun-Jiun Tsai, Feng-Yu Kuo, Wei-Lun Tsai

{"title":"Entecavir vs. tenofovir disoproxil fumarate in the treatment of chronic hepatitis B patients with severe acute exacerbation.","authors":"Chih-Yang Lin, Wei-Chih Sun, Chia-Ming Lu, Wen-Chi Chen, Feng-Woei Tsay, Tzun-Jiun Tsai, Feng-Yu Kuo, Wei-Lun Tsai","doi":"10.1097/MEG.0000000000002709","DOIUrl":"10.1097/MEG.0000000000002709","url":null,"abstract":"Background: The efficacy of different nucleos(t)ide analogs in the treatment of chronic hepatitis B virus (CHB) with severe acute exacerbation (SAE) remained unclear. Thus, this study aimed to compare the short-term efficacy of tenofovir disoproxil fumarate (TDF) and entecavir (ETV) in patients having CHB with SAE.Methods: We analyzed consecutive patients with treatment-naive CHB receiving TDF (n = 36) or ETV (n = 65) for SAE. The primary endpoint was overall mortality or receipt of liver transplantation (LT) by 24 weeks. The secondary endpoints are the comparison of ETV vs. TDF influences on renal function and virological and biochemical responses at 4, 12, 24, and 48 weeks.Results: The baseline characteristics were comparable between the two groups. By 24 weeks, 8 (22%) patients in the TDF group and 10 (15%) patients in the ETV group had either died (n = 15) or received LT (n = 3) ( P = 0.367). Cox-regression multivariate analysis revealed age ( P = 0.003), baseline international normalized ratio of prothrombin time ( P = 0.024), and early presence of hepatic encephalopathy ( P = 0.003) as independent factors associated with mortality or LT. The two groups of patients achieved comparable biochemical and virological responses at 48 weeks. No significant difference was found in the estimated glomerular filtration rate (eGFR) between the TDF and the ETV groups. However, a significant reduction in the eGFR at 48 weeks, as compared with the baseline, was found in each group.Conclusion: TDF and ETV achieved similar short-term clinical outcomes and treatment responses in CHB patients with SAE.","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A pilot study of safety and efficacy comparison of low molecular heparin calcium sequential oral anticoagulants in the treatment of cirrhotic portal vein thrombosis. 低分子肝素钙序贯口服抗凝剂治疗肝硬化门静脉血栓安全性和有效性比较试验研究。

IF 2.3 4区医学

European Journal of Gastroenterology & Hepatology Pub Date : 2024-09-01 Epub Date: 2024-05-16 DOI: 10.1097/MEG.0000000000002787

Jie Zhang, Xiaohong Dang, Lijuan Zhang, Wenhua Li

{"title":"A pilot study of safety and efficacy comparison of low molecular heparin calcium sequential oral anticoagulants in the treatment of cirrhotic portal vein thrombosis.","authors":"Jie Zhang, Xiaohong Dang, Lijuan Zhang, Wenhua Li","doi":"10.1097/MEG.0000000000002787","DOIUrl":"https://doi.org/10.1097/MEG.0000000000002787","url":null,"abstract":"Background: The objective of this study is to compare and assess the efficacy and safety of low-molecular-weight heparin calcium (LMWH-Ca), followed by either warfarin or rivaroxaban, as treatment options for portal vein thrombosis (PVT) in patients with cirrhosis.Methods: In this pilot study, cirrhotic (with liver function score of Child-Pugh A) patients diagnosed with PVT who were not on anticoagulant therapy received 2 weeks of subcutaneous injections of LMWH-Ca. They were then randomized to either warfarin (a full course of oral warfarin for 6 months) or rivaroxaban (a full course of oral rivaroxaban for 2 months), with 30 cases in each group. After a treatment period of up to 6 months, a comparative analysis was performed to assess the efficacy and safety of both groups. Volumetric changes in PVT were monitored dynamically using enhanced computed tomography scans before treatment at week 2 and month 6.Results: There were no statistically significant differences in the clinical characteristics of the patients between the two groups. Rivaroxaban treatment reduced PVT median volume from 1.83 cm3 at week 2 to 0.0 cm3 at month 6 and prevented the worsening of PVT after 6 months of treatment with LMWH-Ca (P < 0.001). On the other hand, warfarin treatment increased PVT median volume from 1.95 cm3 at week 2 to 3.78 cm3 at month 6 (P = 0.002). None of the 30 patients in the rivaroxaban group had clinically significant gastrointestinal bleeding, while 2 of the 30 patients (7%) in the warfarin group had gastrointestinal bleeding (P = 0.317).Conclusion: Rivaroxaban followed by LMWH-Ca is an effective anticoagulant treatment strategy for PVT in cirrhosis.","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Gastroenterology healthcare in LGBTQ+ individuals. LGBTQ+ 人士的肠胃病保健。

IF 2.3 4区医学

European Journal of Gastroenterology & Hepatology Pub Date : 2024-09-01 Epub Date: 2024-06-17 DOI: 10.1097/MEG.0000000000002808

Rosa Coelho, Raquel Gonçalves, Francisco Mendes, Guilherme Macedo

{"title":"Gastroenterology healthcare in LGBTQ+ individuals.","authors":"Rosa Coelho, Raquel Gonçalves, Francisco Mendes, Guilherme Macedo","doi":"10.1097/MEG.0000000000002808","DOIUrl":"10.1097/MEG.0000000000002808","url":null,"abstract":"Lesbian, gay, bisexual, transgender, queer, or questioning individuals, as well as those with another diverse identity (LGBTQ+), present specific nuances in healthcare that physicians must consider in clinical practice. Particularly, gastroenterologists are nowadays facing different issues in several fields regarding LGBTQ+ healthcare, such as endoscopy, inflammatory bowel disease, hepatology, and proctology. In this study, the authors provide a practice-oriented and up-to-date review reinforcing the importance of some of the most prevalent pathologies associated with sexuality that gastroenterologists may encounter in their clinical practice. In terms of endoscopy, authors describe the endoscopic findings related to human papillomavirus (HPV) infection: the esophageal squamous papilloma and cell carcinoma; also highlight the importance of retroflexion maneuver during a routine colonoscopy that allows detection of anal intraepithelial neoplasia lesions that can be anal cancer precursors. Regarding inflammatory bowel disease, some considerations are made about the differential diagnosis with infectious proctitis, and the topic of the risk of anal cancer due to HPV infection, in this specific population, is also addressed. Considering hepatology, the authors review the most important issues related to hepatotropic sexually transmitted infections. The authors also make some comments regarding the possibility of drug-induced liver injury in gender-affirming hormone therapy and pre-exposure prophylaxis for HIV prevention. Finally, considering the proctology field, an up-to-date review is performed regarding anal cancer screening, HPV infection and related diseases, and infectious proctitis management.","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mediating effect of diabetes on the relationship between nonalcoholic fatty liver disease and atherosclerotic cardiovascular disease: a prospective cohort study. 糖尿病对非酒精性脂肪肝与动脉粥样硬化性心血管疾病之间关系的中介效应：一项前瞻性队列研究。

IF 2.3 4区医学

European Journal of Gastroenterology & Hepatology Pub Date : 2024-09-01 Epub Date: 2024-05-20 DOI: 10.1097/MEG.0000000000002794

Wei Yuan, Ying Ran, Jierui Wang, Fei Pei, Liufu Cui, Shuohua Chen, Shouling Wu, Lu Zhou

{"title":"Mediating effect of diabetes on the relationship between nonalcoholic fatty liver disease and atherosclerotic cardiovascular disease: a prospective cohort study.","authors":"Wei Yuan, Ying Ran, Jierui Wang, Fei Pei, Liufu Cui, Shuohua Chen, Shouling Wu, Lu Zhou","doi":"10.1097/MEG.0000000000002794","DOIUrl":"https://doi.org/10.1097/MEG.0000000000002794","url":null,"abstract":"Objective: This study explored the mediating effect of diabetes on the relationship between nonalcoholic fatty liver disease (NAFLD) and atherosclerotic cardiovascular disease (ASCVD).Methods: In this prospective community cohort study, 82 975 participants were enrolled, with the primary outcome being the incidence of new-onset ASCVD. Using the Cox proportional hazards model, the hazard ratio (HR) and 95% confidence interval (CI) for ASCVD occurrence were computed between NAFLD and non-NAFLD groups. The correlation between NAFLD and diabetes was assessed using a binary logistic regression model, and that between NAFLD, diabetes and ASCVD using a mediation model.Results: During follow-up, 9471 ASCVD cases were observed. Compared with individuals without NAFLD, those with NAFLD showed an increased ASCVD risk (HR: 1.424; 95% CI: 1.363-1.488; P < 0.001). Stratifying NAFLD based on metabolic subphenotypes revealed a higher ASCVD risk in the NAFLD combined with diabetes subgroup than in the non-NAFLD subgroup (HR: 1.960; 95% CI: 1.817-2.115; P < 0.001). NAFLD was positively associated with baseline diabetes (odds ratio: 2.983; 95% CI: 2.813-3.163; P < 0.001). Furthermore, NAFLD severity was positively correlated with diabetes risk. Mediation analysis indicated that diabetes partially mediated the effect of NAFLD on ASCVD incidence, accounting for 20.33% of the total effect.Conclusion: NAFLD is an independent predictor of increased ASCVD risk, which may be slightly mediated by diabetes in patients with NAFLD. Evaluating NAFLD and diabetes may be crucial in the early screening and prevention of ASCVD.","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

TOP 100 and detection of colorectal lesions in colon capsule endoscopy: more than meets the eye. TOP 100 和结肠胶囊内窥镜的结肠直肠病变检测：不止于此。

IF 2.3 4区医学

European Journal of Gastroenterology & Hepatology Pub Date : 2024-09-01 Epub Date: 2024-06-24 DOI: 10.1097/MEG.0000000000002809

Tiago Lima Capela, Cátia Arieira, Sofia Xavier, Tiago Cúrdia Gonçalves, Pedro Boal Carvalho, Bruno Rosa, José Cotter

{"title":"TOP 100 and detection of colorectal lesions in colon capsule endoscopy: more than meets the eye.","authors":"Tiago Lima Capela, Cátia Arieira, Sofia Xavier, Tiago Cúrdia Gonçalves, Pedro Boal Carvalho, Bruno Rosa, José Cotter","doi":"10.1097/MEG.0000000000002809","DOIUrl":"10.1097/MEG.0000000000002809","url":null,"abstract":"Colon capsule endoscopy (CCE) is a well-known method for the detection of colorectal lesions. Nevertheless, there are no studies reporting the accuracy of TOP 100, a CCE software tool, for the automatic detection of colorectal lesions in CCE. We aimed to evaluate the performance of TOP 100 in detecting colorectal lesions in patients submitted to CCE for incomplete colonoscopy compared with classic reading. A retrospective cohort study including adult patients submitted to CCE (PillCam COLON 2; Medtronic) for incomplete colonoscopy. Blinded for each other's evaluation, one experienced reader analyzed the TOP 100 images and the other performed classic reading to identify colorectal lesions. Detection of colorectal lesions, namely polyps, angioectasia, blood, diverticula, erosions/ulcers, neoplasia, and subepithelial lesions was assessed and TOP 100 performance was evaluated compared with the gold standard (classic reading). A total of 188 CCEs were included. Prevalence of colorectal lesions, polyps, angioectasia, blood, diverticula, erosions/ulcers, neoplasia, and subepithelial lesions were 77.7, 54.3, 8.5, 1.6, 50.0, 0.5, 0.5, and 1.1%, respectively. TOP 100 had a sensitivity of 92.5%, specificity of 69.1%, negative predictive value of 72.5%, positive predictive value of 91.2%, and accuracy of 87.2% for detecting colorectal lesions. TOP 100 had a sensitivity of 89.2%, specificity of 84.9%, negative predictive value of 86.9%, positive predictive value of 87.5%, and accuracy of 87.2% in detecting polyps. All colorectal lesions other than polyps were identified with 100% accuracy by TOP 100. TOP 100 has been shown to be a simple and useful tool in assisting the reader in the prompt identification of colorectal lesions in CCE.","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Vedolizumab versus ustekinumab in Crohn's disease with prior anti-tumor necrosis factor failure: an updated meta-analysis. 曾用抗肿瘤坏死因子治疗失败的克罗恩病中维多单抗与乌司他单抗的比较：最新荟萃分析。

IF 2.3 4区医学

European Journal of Gastroenterology & Hepatology Pub Date : 2024-09-01 Epub Date: 2024-07-02 DOI: 10.1097/MEG.0000000000002817

Natália Junkes Milioli, Matheus Vanzin Fernandes, Tulio L Correa, Vanio Antunes, Otávio Cosendey Martins, Cynthia Florêncio de Mesquita, Stefano Baraldo, Federica Furfaro

{"title":"Vedolizumab versus ustekinumab in Crohn's disease with prior anti-tumor necrosis factor failure: an updated meta-analysis.","authors":"Natália Junkes Milioli, Matheus Vanzin Fernandes, Tulio L Correa, Vanio Antunes, Otávio Cosendey Martins, Cynthia Florêncio de Mesquita, Stefano Baraldo, Federica Furfaro","doi":"10.1097/MEG.0000000000002817","DOIUrl":"10.1097/MEG.0000000000002817","url":null,"abstract":"Ustekinumab and vedolizumab are key treatment options for Crohn's disease patients who fail anti-tumor necrosis factor (TNF) therapy. This updated meta-analysis aims to compare the efficacy and safety of these two drugs. We performed a systematic review in PubMed, Embase , and Cochrane databases searching for randomized and nonrandomized studies comparing vedolizumab versus ustekinumab in patients with Crohn's disease with previous anti-TNF failure or intolerance. The primary outcome was steroid-free clinical remission (SFR) at the pos-induction (12-16 weeks) and maintenance period (48-52 weeks). The odds ratio (OR) was used for binary outcomes with their respective 95% confidence interval (CI). Heterogeneity was assessed using the Cochran Q test and I2 statistics. This meta-analysis included 11 studies and 2724 patients. There was a significant difference favoring ustekinumab in SFR at pos-induction (OR, 1.44; 95% CI, 1.11-1.88; P = 0.006; I2 = 27%) and maintenance periods (OR, 1.86; 95% CI, 1.23-2.82; P = 0.003; I2 = 80%), in clinical remission at pos-induction period (OR, 2.04; 95% CI, 1.58-2.63; P < 0.001; I2 = 3%), and in treatment discontinuation due to adverse events (OR, 0.31; 95% CI, 0.16-0.60; P < 0.001; I2 = 0%). In patients with Crohn's disease with prior anti-TNF failure, ustekinumab showed higher SFR during both the pos-induction and maintenance period and a lower rate of treatment discontinuation due to adverse events.","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of a set of measurable outcome indicators for Flemish patients with inflammatory bowel disease. 为佛兰德炎症性肠病患者制定一套可衡量的结果指标。

IF 2.3 4区医学

European Journal of Gastroenterology & Hepatology Pub Date : 2024-09-01 Epub Date: 2024-06-19 DOI: 10.1097/MEG.0000000000002804

Liselotte Fierens, Peter Bossuyt, Filip Baert, Didier Baert, Caroline Weltens, Marga Lavaerts, Kris Vanhaecht, Frank E Rademakers, Marc Ferrante

{"title":"Development of a set of measurable outcome indicators for Flemish patients with inflammatory bowel disease.","authors":"Liselotte Fierens, Peter Bossuyt, Filip Baert, Didier Baert, Caroline Weltens, Marga Lavaerts, Kris Vanhaecht, Frank E Rademakers, Marc Ferrante","doi":"10.1097/MEG.0000000000002804","DOIUrl":"10.1097/MEG.0000000000002804","url":null,"abstract":"Objective: Uniform and standardised quality measurement allows care assessment and improvement. Following a pragmatic consensus method we aimed to agree on a selection of measurable quality indicators that can be used to assess, benchmark and gradually improve inflammatory bowel disease (IBD) care in Flanders.Methods: Of 49 structures, 135 processes and 37 outcome indicators identified through literature, 58 were preselected and reformulated into measurable outcome indicators by four IBD physicians. A larger expert group scored the 58 indicators on a 10-point importance scale twice, endorsed by patient and expert perspectives in between rounds. Additional items could be suggested. A final selection and subset of indicators with room for improvement were agreed upon during a consensus meeting.Results: Fifty indicators received an importance score of 7 or higher by ≥80% of the participants (seven IBD nurses, one abdominal surgeon, one chief medical officer and 31 IBD physicians including two paediatricians). Eight indicators scored highly important by 60-80%, two indicators reintroduced by patients and one newly suggested, were discussed during the consensus meeting. Among 26 participants, eight indicators were agreed to be added to the final selection. Of the 58 selected items, 19 were retained in the improvement subset, related to patient-reported outcomes, use of hospital services and survival, patient characteristics, monitoring of disease activity and remission, endoscopy guidelines, infection prevention, steroid and other medication use.Conclusion: Fifty-eight indicators were selected to assess IBD care in Flanders and a subset of 19 for use in clinical practice to steer quality improvement initiatives.","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of online chat-based artificial intelligence responses about inflammatory bowel disease and diet. 评估基于在线聊天的人工智能对炎症性肠病和饮食的反应。

IF 2.3 4区医学

European Journal of Gastroenterology & Hepatology Pub Date : 2024-09-01 Epub Date: 2024-07-08 DOI: 10.1097/MEG.0000000000002815

Haider A Naqvi, Thilini Delungahawatta, Joseph O Atarere, Sumanth Kumar Bandaru, Jasmine B Barrow, Mark C Mattar

{"title":"Evaluation of online chat-based artificial intelligence responses about inflammatory bowel disease and diet.","authors":"Haider A Naqvi, Thilini Delungahawatta, Joseph O Atarere, Sumanth Kumar Bandaru, Jasmine B Barrow, Mark C Mattar","doi":"10.1097/MEG.0000000000002815","DOIUrl":"10.1097/MEG.0000000000002815","url":null,"abstract":"Introduction: The USA has the highest age-standardized prevalence of inflammatory bowel disease (IBD). Both genetic and environmental factors have been implicated in IBD flares and multiple strategies are centered around avoiding dietary triggers to maintain remission. Chat-based artificial intelligence (CB-AI) has shown great potential in enhancing patient education in medicine. We evaluate the role of CB-AI in patient education on dietary management of IBD.Methods: Six questions evaluating important concepts about the dietary management of IBD which then were posed to three CB-AI models - ChatGPT, BingChat, and YouChat three different times. All responses were graded for appropriateness and reliability by two physicians using dietary information from the Crohn's and Colitis Foundation. The responses were graded as reliably appropriate, reliably inappropriate, and unreliable. The expert assessment of the reviewing physicians was validated by the joint probability of agreement for two raters.Results: ChatGPT provided reliably appropriate responses to questions on dietary management of IBD more often than BingChat and YouChat. There were two questions that more than one CB-AI provided unreliable responses to. Each CB-AI provided examples within their responses, but the examples were not always appropriate. Whether the response was appropriate or not, CB-AIs mentioned consulting with an expert in the field. The inter-rater reliability was 88.9%.Discussion: CB-AIs have the potential to improve patient education and outcomes but studies evaluating their appropriateness for various health conditions are sparse. Our study showed that CB-AIs have the ability to provide appropriate answers to most questions regarding the dietary management of IBD.","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0