Journal of the Canadian Association of Gastroenterology最新文献

{"title":"Automated Detection of Anatomical Landmarks During Colonoscopy Using a Deep Learning Model.","authors":"Mahsa Taghiakbari, Sina Hamidi Ghalehjegh, Emmanuel Jehanno, Tess Berthier, Lisa di Jorio, Saber Ghadakzadeh, Alan Barkun, Mark Takla, Mickael Bouin, Eric Deslandres, Simon Bouchard, Sacha Sidani, Yoshua Bengio, Daniel von Renteln Md","doi":"10.1093/jcag/gwad017","DOIUrl":"10.1093/jcag/gwad017","url":null,"abstract":"<p><strong>Background and aims: </strong>Identification and photo-documentation of the ileocecal valve (ICV) and appendiceal orifice (AO) confirm completeness of colonoscopy examinations. We aimed to develop and test a deep convolutional neural network (DCNN) model that can automatically identify ICV and AO, and differentiate these landmarks from normal mucosa and colorectal polyps.</p><p><strong>Methods: </strong>We prospectively collected annotated full-length colonoscopy videos of 318 patients undergoing outpatient colonoscopies. We created three nonoverlapping training, validation, and test data sets with 25,444 unaltered frames extracted from the colonoscopy videos showing four landmarks/image classes (AO, ICV, normal mucosa, and polyps). A DCNN classification model was developed, validated, and tested in separate data sets of images containing the four different landmarks.</p><p><strong>Results: </strong>After training and validation, the DCNN model could identify both AO and ICV in 18 out of 21 patients (85.7%). The accuracy of the model for differentiating AO from normal mucosa, and ICV from normal mucosa were 86.4% (95% CI 84.1% to 88.5%), and 86.4% (95% CI 84.1% to 88.6%), respectively. Furthermore, the accuracy of the model for differentiating polyps from normal mucosa was 88.6% (95% CI 86.6% to 90.3%).</p><p><strong>Conclusion: </strong>This model offers a novel tool to assist endoscopists with automated identification of AO and ICV during colonoscopy. The model can reliably distinguish these anatomical landmarks from normal mucosa and colorectal polyps. It can be implemented into automated colonoscopy report generation, photo-documentation, and quality auditing solutions to improve colonoscopy reporting quality.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"6 4","pages":"145-151"},"PeriodicalIF":0.0,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10395661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9992833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicentre Analysis of Cost, Uptake and Safety of Canadian Multidisciplinary Pancreatic Cyst Guidelines.","authors":"Kevin Verhoeff,&nbsp;Alexandria N Webb,&nbsp;Daniel Krys,&nbsp;Danielle Anderson,&nbsp;David L Bigam,&nbsp;Christopher I Fung","doi":"10.1093/jcag/gwad001","DOIUrl":"https://doi.org/10.1093/jcag/gwad001","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cystic lesions (PCLs) are common, with several guidelines providing surveillance recommendations. The Canadian Association of Radiologists published surveillance guidelines (CARGs) intended to provide simplified, cost-effective and safe recommendations. This study aimed to evaluate cost savings of CARGs compared to other North American guidelines including American Gastroenterology Association guidelines (AGAG) and American College of Radiology guidelines (ACRG), and to evaluate CARG safety and uptake.</p><p><strong>Methods: </strong>This is a multicentre retrospective study evaluating adults with PCL from a single health zone. MRIs completed from September 2018-2019, one year after local CARG guideline implementation, were reviewed to identify PCLs. All imaging following 3-4 years of CARG implementation was reviewed to evaluate true costs, missed malignancy and guideline uptake. Modelling, including MRI and consultation, predicted and compared costs associated with surveillance based on CARGs, AGAGs and ACRGs.</p><p><strong>Results: </strong>6698 abdominal MRIs were reviewed with 1001 (14.9%) identifying PCL. Application of CARGs over 3.1 years demonstrated a >70% cost reduction compared to other guidelines. Similarly, the modelled cost of surveillance for 10-years for each guideline was $516,183, $1,908,425 and $1,924,607 for CARGs, AGAGs and ACRGs respectively. Of patients suggested to not require further surveillance per CARGs, approximately 1% develop malignancy with fewer being candidates for surgical resection. Overall, 44.8% of initial PCL reports provided CARG recommendations while 54.3% of PCLs were followed as per CARGs.</p><p><strong>Conclusions: </strong>CARGs are safe and offer substantial cost and opportunity savings for PCL surveillance. These findings support Canada-wide implementation with close monitoring of consultation requirements and missed diagnoses.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"6 2","pages":"86-93"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10071295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9271410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequities in Rural and Urban Health Care Utilization Among Individuals Diagnosed With Inflammatory Bowel Disease: A Retrospective Population-Based Cohort Study From Saskatchewan, Canada.","authors":"Juan Nicolás Peña-Sánchez,&nbsp;Jessica Amankwah Osei,&nbsp;Noelle Rohatinsky,&nbsp;Xinya Lu,&nbsp;Tracie Risling,&nbsp;Ian Boyd,&nbsp;Kendall Wicks,&nbsp;Mike Wicks,&nbsp;Carol-Lynne Quintin,&nbsp;Alyssa Dickson,&nbsp;Sharyle A Fowler","doi":"10.1093/jcag/gwac015","DOIUrl":"https://doi.org/10.1093/jcag/gwac015","url":null,"abstract":"<p><strong>Background: </strong>Rural dwellers with inflammatory bowel disease (IBD) face barriers to accessing specialized health services. We aimed to contrast health care utilization between rural and urban residents diagnosed with IBD in Saskatchewan, Canada.</p><p><strong>Methods: </strong>We completed a population-based retrospective study from 1998/1999 to 2017/2018 using administrative health databases. A validated algorithm was used to identify incident IBD cases aged 18+. Rural/urban residence was assigned at IBD diagnosis. Outpatient (gastroenterology visits, lower endoscopies, and IBD medications claims) and inpatient (IBD-specific and IBD-related hospitalizations, and surgeries for IBD) outcomes were measured after IBD diagnosis. Cox proportional hazard, negative binomial, and logistic models were used to evaluate associations adjusting by sex, age, neighbourhood income quintile, and disease type. Hazard ratios (HR), incidence rate ratios (IRR), odds ratios (OR), and 95% confidence intervals (95% CI) were reported.</p><p><strong>Results: </strong>From 5,173 incident IBD cases, 1,544 (29.8%) were living in rural Saskatchewan at IBD diagnosis. Compared to urban dwellers, rural residents had fewer gastroenterology visits (HR = 0.82, 95% CI: 0.77-0.88), were less likely to have a gastroenterologist as primary IBD care provider (OR = 0.60, 95% CI: 0.51-0.70), and had lower endoscopies rates (IRR = 0.92, 95% CI: 0.87-0.98) and more 5-aminosalicylic acid claims (HR = 1.10, 95% CI: 1.02-1.18). Rural residents had a higher risk and rates of IBD-specific (HR = 1.23, 95% CI: 1.13-1.34; IRR = 1.22, 95% CI: 1.09-1.37) and IBD-related (HR = 1.20, 95% CI: 1.11-1.31; IRR = 1.23, 95% CI: 1.10-1.37) hospitalizations than their urban counterparts.</p><p><strong>Conclusion: </strong>We identified rural-urban disparities in IBD health care utilization that reflect rural-urban inequities in the access to IBD care. These inequities require attention to promote health care innovation and equitable management of patients with IBD living in rural areas.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"6 2","pages":"55-63"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/5b/gwac015.PMC10071297.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9271411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyeloduodenal Fistula in Xanthogranulomatous Pyelonephritis.","authors":"Grace Wang,&nbsp;Parul Tandon,&nbsp;Christopher Wayne Teshima","doi":"10.1093/jcag/gwac008","DOIUrl":"https://doi.org/10.1093/jcag/gwac008","url":null,"abstract":"","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"6 2","pages":"53-54"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10071293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9271408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Preference-Based, Generic and Disease-Specific Health-Related Quality of Life in Pediatric Inflammatory Bowel Disease.","authors":"Naazish S Bashir,&nbsp;Thomas D Walters,&nbsp;Anne M Griffiths,&nbsp;Anthony Otley,&nbsp;Jeff Critch,&nbsp;Wendy J Ungar","doi":"10.1093/jcag/gwac034","DOIUrl":"https://doi.org/10.1093/jcag/gwac034","url":null,"abstract":"<p><strong>Objective: </strong>Generic preference-based HRQOL assessments used expressly for economic evaluation have not been examined in pediatric Crohn's disease (CD) and ulcerative colitis (UC). The objective was to further assess the construct validity of preference-based HRQOL measures in pediatric IBD by comparing the Child Health Utility 9 Dimensions (CHU9D) and Health Utilities Index (HUI) to the disease-specific IMPACT-III and to the generic PedsQL in children with CD and with UC.</p><p><strong>Methods: </strong>The CHU9D, HUI, IMPACT-III and/or PedsQL were administered to Canadian children aged 6 to 18 years with CD and UC. CHU9D total and domain utilities were calculated using adult and youth tariffs. HUI total and attribute utilities were determined for the HUI2 and HUI3. Total scores for IMPACT-III and PedsQL were determined. Spearman correlations were calculated between generic preference-based utilities and the IMPACT-III and PedsQL scores.</p><p><strong>Results: </strong>The questionnaires were administered to 157 children with CD and 73 children with UC. Moderate to strong correlations were observed between the CHU9D, HUI2, HUI3 and the disease-specific IMPACT-III or generic PedsQL. As hypothesized, domains with similar constructs demonstrated stronger correlations, such as the Pain and Well-being domains.</p><p><strong>Conclusions: </strong>While all questionnaires were moderately correlated with the IMPACT-III and PedsQL questionnaires, the CHU9D using youth tariffs and the HUI3 were most strongly correlated and would be suitable choices to generate health utilities for children with CD or UC for the purpose of economic evaluation of treatments in pediatric IBD.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"6 2","pages":"73-79"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/6a/gwac034.PMC10071296.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9264598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistently High Rates of Abdominal Computed Tomography Imaging Among Patients With Inflammatory Bowel Disease Who Present to the Emergency Department.","authors":"Rana Kandel,&nbsp;Maria Merlano,&nbsp;Pearl Tan,&nbsp;Gurmun Brar,&nbsp;Ranjeeta Mallick,&nbsp;Blair Macdonald,&nbsp;Catherine Dubé,&nbsp;Sanjay Murthy,&nbsp;Ian Stiell,&nbsp;Jeffery D McCurdy","doi":"10.1093/jcag/gwac029","DOIUrl":"https://doi.org/10.1093/jcag/gwac029","url":null,"abstract":"<p><strong>Background: </strong>Recent guidelines recommended judicious use of abdominal computed tomography (CT) in the emergency department (ED) for inflammatory bowel disease. Trends in CT utilization over the last decade, including since the implementation of these guidelines, remain unknown.</p><p><strong>Methods: </strong>We performed a single-centre, retrospective study between 2009 and 2018 to assess trends in CT utilization within 72 h of an ED encounter. Changes in the annual rates of CT imaging among adults with IBD were estimated by Poisson regression and CT findings by Cochran-Armitage or Cochran-Mantel Haenszel tests.</p><p><strong>Results: </strong>A total of 3000 abdominal CT studies were performed among 14,783 ED encounters. CT utilization increased annually by 2.7% in Crohn's disease (CD) (95% confidence interval [CI], 1.2 to 4.3; <i>P</i> = 0.0004), 4.2% in ulcerative colitis (UC) (95% CI, 1.7 to 6.7; <i>P</i> = 0.0009) and 6.3% in IBD unclassifiable (95% CI, 2.5 to 10.0; <i>P</i> = 0.0011). Among encounters with gastrointestinal symptoms, 60% with CD and 33% with UC underwent CT imaging in the final year of the study. Urgent CT findings (obstruction, phlegmon, abscess or perforation) and urgent penetrating findings alone (phlegmon, abscess or perforation) comprised 34% and 11% of CD findings, and 25% and 6% of UC findings, respectively. The CT findings remained stable overtime for both CD (<i>P</i> = 0.13) and UC (<i>P</i> = 0.17).</p><p><strong>Conclusion: </strong>Our study demonstrated persistently high rates of CT utilization among patients with IBD who presented to the ED over the last decade. Approximately one third of scans demonstrated urgent findings, with a minority demonstrating urgent penetrating findings. Future studies should aim to identify patients in whom CT imaging is most appropriate.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"6 2","pages":"64-72"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10071298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9264600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nationwide Survey of Training Pathways and Practice Trends of Endoscopic Submucosal Dissection in Canada.","authors":"Suqing Li,&nbsp;Jeffrey Mosko,&nbsp;Gary May,&nbsp;Christopher Teshima","doi":"10.1093/jcag/gwac037","DOIUrl":"https://doi.org/10.1093/jcag/gwac037","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic submucosal dissection (ESD) has become an established standard for endoscopic removal of large gastrointestinal (GI) lesions and early GI malignancies. However, ESD is technically challenging and requires significant health care infrastructure. As such, its adoption in Canada has been relatively slow. The practice of ESD across Canada remains unclear. Our study aimed to provide a descriptive overview of training pathways and practice trends of ESD in Canada.</p><p><strong>Methods: </strong>Current ESD practitioners across Canada were identified and invited to participate in an anonymous cross-sectional survey.</p><p><strong>Results: </strong>Twenty-seven ESD practitioners were identified; survey response rate was 74%. Respondents were from 15 different institutions. All practitioners underwent international ESD training of some type. Fifty per cent pursued long-term ESD training programs. Ninety-five per cent attended short-term training courses. Sixty per cent and 40% performed hands-on live human upper and lower GI ESD, respectively, before independent practice. In practice, 70% saw an increase per year in number of procedures performed from 2015 to 2019. Sixty per cent were dissatisfied with their institution's health care infrastructure to support ESD. Thirty-five per cent perceived their institution as supportive of expanding the practice of ESD.</p><p><strong>Conclusions: </strong>Several challenges exist to the adoption of ESD in Canada. Training pathways are variable, with no set standards. In practice, practitioners express dissatisfaction with access to necessary infrastructure and feel poorly supported in expanding the practice of ESD. As ESD is increasingly the accepted standard for the treatment of many neoplastic GI lesions, greater collaboration between practitioners and institutions is crucial to standardize training and ensure patient access.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"6 2","pages":"80-85"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10071294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9264599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A221 EFFECT OF PROXIMITY TO A SPECIALTY TERTIARY CENTRE ON OUTCOMES IN INFLAMMATORY BOWEL DISEASE: A POPULATION-BASED RETROSPECTIVE COHORT STUDY","authors":"M. Mikail, Q. Alkhateeb, V. Pope, R. Khanna","doi":"10.1093/jcag/gwac036.221","DOIUrl":"https://doi.org/10.1093/jcag/gwac036.221","url":null,"abstract":"Abstract Background The etiology of inflammatory bowel disease (IBD) is unknown; however, developed nations such as Canada ranking amongst the highest worldwide. With many diseases patients in urban and rural areas have different access to care and resources. Purpose To describe the differences in outpatient healthcare utilization, use of biologic agents and complication of IBD based on proximity to a tertiary health care centre. Method A retrospective cohort study was conducted comparing IBD patients seen in IBD clinics at affiliated with Western University in London, Canada between August 2019 – December 2019. IBD patients were compared on their use of outpatient healthcare utilization, biologic agents and IBD complications based on their proximity to a tertiary care centre (>100 km and <100 km). Patients residing >100 km from a tertiary centre were termed “rural” while <100 km from a tertiary centre were termed “urban.” Retrospective chart review occurred over a six-month period between January to June 2021. Result(s) A total of 481 were reviewed. Of those, 97 (UC, n=29; CD, n=68) and 95 (UC, n=30; CD, n=65) met inclusion for the urban and rural groups respectively. Patient demographics were similar between the two groups except IBD disease location with pancolitis seen more commonly in urban patients compared to ileocolonic in rural patients (urban, n=39; rural, n=34). IBD patients in both groups had similar number of appointments (urban, n=20.1 ± 13.8; rural, n=17.5 ± 12.1) and endoscopic procedures (urban, n= 4.9 ± 3.1; rural, n= 4.7 ± 3.2) with their gastroenterologists. More urban patients were managed with no therapy for their IBD (urban, n=16; rural, n=5). A higher rate of rural patients were managed with biologics (urban, n=56; rural, n=66) and combination therapy (urban, n=16; rural, n=27). The most common related IBD-related complications were IBD flares (urban, n=55; rural, n=60), intestinal strictures (urban, n=25; rural, n=34), intestinal obstructions (urban, n=10; rural, n=23) and rectal/genitourinary fistulas (urban, n=6; rural, n=21). Similar numbers of intra-abdominal surgery were seen between both groups with partial bowel resection (urban, n=13; rural, n=12) and right hemicolectomy (urban, n=10; rural, n=18) as the predominant surgery in urban and rural patients, respectively. Conclusion(s) This study demonstrated outpatient healthcare utilization when attending specialty gastroenterology appointments and outpatient endoscopies were numerically similar in rural and urban patients. IBD patient residing further from a tertiary care centre were numerically more likely to be managed with biologics and combination therapy. However the dataset is small and generalizations cannot be made. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"6 1","pages":"57 - 57"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60815316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A217 A REVIEW OF MOBILE HEALTH APPLICATIONS FOR INDIVIDUALS LIVING WITH INFLAMMATORY BOWEL DISEASE USING MOBILE APPLICATION RATING SCALE (MARS)","authors":"N. Jannati, S. Salehinejad, E. Kuenzig, J. Peña-Sánchez","doi":"10.1093/jcag/gwac036.217","DOIUrl":"https://doi.org/10.1093/jcag/gwac036.217","url":null,"abstract":"Abstract Background Inflammatory bowel disease (IBD) is a chronic disorder that can be managed but not cured. The relapsing and remitting symptoms of IBD impact patients' quality of life and is associated with considerable healthcare costs. Different mobile health apps have been developed around the world for IBD and other chronic medical conditions. These apps can potentially decrease healthcare utilization and the burden of the disease. Purpose We aimed to review IBD mobile health apps available in English and evaluate their quality and content. Method We searched the Apple Store and Play Store in July 2022 using IBD-related keywords (e.g., “IBD,” “Crohn,” “Crohns,” “colitis,” “ulcerative colitis,” and “inflammatory bowel disease.”) to identify apps for iOS and Android devices, respectively. We included apps available in English, designed specifically for IBD, and free to download and use. Two researchers reviewed, rated, and evaluated the retrieved apps independently. The Mobile App Rating Scale (MARS) was used to rate the included apps. The MARS rates apps on a scale of 1 to 5 and includes an overall score as well as scores for engagement, functionality, information, aesthetics, and subject quality. A score ≥3 is deemed acceptable. Result(s) Search queries yielded 88 relevant apps, of which 38 met the inclusion criteria and were included in this review. The included apps for IBD were most tracking and monitoring symptoms of the disease (n=22). Two of the apps were affiliated with universities, and three of the apps were specifically developed for children. In addition, 11 apps were designed for IBD, regardless of disease subtype (Crohn’s disease [CD] or ulcerative colitis [UC]), and 27 apps were designed specifically for either UC or CD. The mean MARS score for IBD apps was 3.3 (SD=0.6), with more than half deemed acceptable. Apps scored highest on the functionality (mean=3.7, SD=0.6) and information (mean=3.6, SD=0.5) dimension of MARS and lowest on the engagement dimension (mean=3, SD=0.8). Image Conclusion(s) Most IBD-related apps provide acceptable information and functionality but should improve their engagement to be welcomed by users. This review provides a roadmap for improving available apps and future app development for individuals with IBD. App developers in the field of IBD must ensure they create high-quality, engaging, esthetic and evidence-based apps. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"6 1","pages":"54 - 55"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44812738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A210 THE BURDEN OF IBD HOSPITALIZATION IN CANADA: AN ASSESSMENT OF THE CURRENT AND FUTURE BURDEN IN A NATION-WIDE ANALYSIS","authors":"S. Coward, E. Benchimol, C. Bernstein, J. A. Avina-Zubieta, A. Bitton, L. Hracs, J. Jones, E. Kuenzig, L. Lu, S. Murthy, Z. Nugent, A. Otley, R. Panaccione, J. Peña-Sánchez, H. Singh, L. Targownik, J. Windsor, G. Kaplan","doi":"10.1093/jcag/gwac036.210","DOIUrl":"https://doi.org/10.1093/jcag/gwac036.210","url":null,"abstract":"Abstract Background Hospitalizations pose a significant burden on both the individual and the healthcare system. Those with inflammatory bowel disease (IBD) are at increased risk of hospitalization as compared to the general population due to flaring of disease activity and complications related to IBD. The advent of biologics over the past twenty years may have influenced the rates of hospitalization for IBD. Purpose To assess current and forecast the overall hospitalization rates of those with IBD stratified by types of hospitalizations (all cause hospitalizations, IBD-related, and IBD-specific). Method Population-based administrative data on hospitalization of IBD (2002-2014) were obtained from: AB, BC, MB, and SK. Data were age and sex standardized to the matching year and aggregated into a representative sample of the Canadian population. Hospitalization rates were assessed as follows: 1. All cause hospitalizations: all admissions regardless of indication; 2. IBD-specific: an admission directly resulting from IBD (e.g., IBD-flare); 3. IBD-related: an admission for IBD, or a symptom or comorbidity associated with IBD (e.g. rheumatoid arthritis). Using prevalence estimates from the provinces, hospitalization rates (per 100 persons with IBD) were calculated, with 95% confidence intervals (CI). Autoregressive Integrated Moving Average models were created to estimate number of hospitalizations and corresponding prevalence to forecast hospitalization rates to 2030 with 95% prediction intervals (PI). Poisson (or negative binomial) regression estimated the Average Annual Percentage Change (AAPC), with 95% CIs, of the forecasted data. Result(s) In 2002 there were 35.3 per 100 (95%CI: 34.7, 35.9) all cause hospitalizations for IBD patients and this decreased to 24.9 per 100 (24.5, 25.2) in 2014. Similar trends were seen for IBD-specific hospitalizations [16.8 per 100 (95%CI: 16.4, 17.2) in 2002 to 8.7 per 100 (95%CI: 8.5, 9.0) in 2014] and IBD-related (22.6 per 100 (95%CI: 22.1, 23.1) in 2002 to 13.4 per 100 (95%CI: 13.2, 13.7) in 2014). When forecasted out to 2030 all hospitalization types were significantly decreasing—the AAPC for all cause hospitalizations was -2.12% (95%CI: -2.31, -1.93), -3.77% (95%CI: -4.63, -3.08) for IBD-specific, and -3.09% (95%CI: -3.65, -2.62) for IBD-related. By 2030, the rates of hospitalization are forecasted to be 17.0 per 100 (95%PI: 16.2, 17.9), 4.6 per 100 (95%PI: 3.7, 5.4), and 7.9 per 100 (95%PI: 6.9, 8.9) for all cause, IBD-specific, and IBD-related, respectively. Image Conclusion(s) In Canada, rates of hospitalizations for those with IBD have decreased from 2002 to 2014. The use of anti-TNF therapy in conjunction with the evolution of clinical monitoring, management and guidelines, likely has contributed to dropping hospitalization rates. Forecast models estimate a continued drop in hospitalization rates out to 2030. Importantly, healthcare resource planning should account for the shift from hospital-based to cli","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"6 1","pages":"48 - 49"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41547511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}