United European Gastroenterology Journal最新文献

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Composite Lymphoma: A Rare Case of Vomiting.
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-01-31 DOI: 10.1002/ueg2.12768
Changqin Liu, Dongyan Han, Xiaomin Sun
{"title":"Composite Lymphoma: A Rare Case of Vomiting.","authors":"Changqin Liu, Dongyan Han, Xiaomin Sun","doi":"10.1002/ueg2.12768","DOIUrl":"https://doi.org/10.1002/ueg2.12768","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
MRI Volumetric Changes in Perianal Fistulizing Crohn's Disease: Moving Toward a Novel Outcome Measure for Therapeutic Response.
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-01-30 DOI: 10.1002/ueg2.12765
Raja Atreya, Markus F Neurath
{"title":"MRI Volumetric Changes in Perianal Fistulizing Crohn's Disease: Moving Toward a Novel Outcome Measure for Therapeutic Response.","authors":"Raja Atreya, Markus F Neurath","doi":"10.1002/ueg2.12765","DOIUrl":"https://doi.org/10.1002/ueg2.12765","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
The Role of Environmental Factors Prior to Diagnosis on the Activity and Severity of Inflammatory Bowel Diseases-Results From the Prospective Population-Based Copenhagen Inflammatory Bowel Disease Inception Cohort.
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-01-29 DOI: 10.1002/ueg2.12737
Mohamed Attauabi, Gorm Roager Madsen, Flemming Bendtsen, Johan Burisch, Jakob Benedict Seidelin
{"title":"The Role of Environmental Factors Prior to Diagnosis on the Activity and Severity of Inflammatory Bowel Diseases-Results From the Prospective Population-Based Copenhagen Inflammatory Bowel Disease Inception Cohort.","authors":"Mohamed Attauabi, Gorm Roager Madsen, Flemming Bendtsen, Johan Burisch, Jakob Benedict Seidelin","doi":"10.1002/ueg2.12737","DOIUrl":"https://doi.org/10.1002/ueg2.12737","url":null,"abstract":"<p><strong>Background: </strong>The influence of environmental factors on the severity of early inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is unclear. Herein, we aimed to investigate the role of environmental factors in the initial phenotype, activity, and severity of IBD.</p><p><strong>Methods: </strong>Copenhagen IBD Inception Cohort is a prospective population-based cohort of patients with newly diagnosed IBD between May 2021 and May 2023. Data on environmental factors were captured at IBD diagnosis using International Organisation of IBD (IOIBD) and HeartDiet questionnaires. Environmental factors' influence on outcome was analyzed and odds ratios (aOR) were adjusted for age, gender, and disease characteristics (adjusted OR, aOR [95% confidence interval]).</p><p><strong>Results: </strong>In total, 208 and 128 patients with incident UC and CD, respectively, were included. Active smoking was associated with increased risk of CD-related hospitalization (aOR = 2.84 [1.03; 7.88]) and stricturing phenotype (aOR = 5.28 [1.76; 15.85]) but lower risk of severe UC course (aOR = 0.28 [0.08; 0.95]). Further, previous smoking was not associated with negative effects in patients with CD in terms of early need for biologics, surgery, or hospitalization. In terms of diets, daily consumption of fruits (aOR = 0.27 [0.07; 0.99]) or vegetables (aOR = 0.27 [0.09; 0.80]) was inversely associated with stricturing CD, whereas whole meal bread was associated with reduced risk of severe CD activity (aOR = 0.40 [0.16; 0.98]).</p><p><strong>Conclusions: </strong>This prospective population-based study highlighted several environmental factors associated with the initial severity and activity of IBD, emphasizing their pivotal role in the initial disease burden and giving guidance to personalized patient counseling.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Inadequate Therapy Response on Advanced Therapy in Ulcerative Colitis Adult Patients: A Retrospective Analysis of German Health Claims Data.
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-01-29 DOI: 10.1002/ueg2.12755
Axel Dignass, Irina Blumenstein, Carolina Schwedhelm, Katrin Strassen, Leonie Kunk, Sophie Marquardt, Anna Seiffert, Nataliia Kulchytska, Ivonne Hänsel, Alexa Benson, Agnes Kisser
{"title":"Inadequate Therapy Response on Advanced Therapy in Ulcerative Colitis Adult Patients: A Retrospective Analysis of German Health Claims Data.","authors":"Axel Dignass, Irina Blumenstein, Carolina Schwedhelm, Katrin Strassen, Leonie Kunk, Sophie Marquardt, Anna Seiffert, Nataliia Kulchytska, Ivonne Hänsel, Alexa Benson, Agnes Kisser","doi":"10.1002/ueg2.12755","DOIUrl":"https://doi.org/10.1002/ueg2.12755","url":null,"abstract":"<p><strong>Background: </strong>The treatment landscape for active ulcerative colitis is rapidly evolving and current real-world evidence on response to advanced therapy is limited. This study aimed to determine indicators of inadequate therapeutic response among patients with ulcerative colitis in Germany initiating advanced therapy.</p><p><strong>Methods: </strong>This retrospective analysis used German claims data (2015-2022) from adult patients (≥ 18 years). The prevalence and incidence of ulcerative colitis (ICD-10-GM: K51.X) were estimated. Inadequate response to therapy was evaluated in patients initiating advanced therapy based on eight predefined indicators observed for 12 months following dispensation of index treatment.</p><p><strong>Results: </strong>Mean ulcerative colitis patient age in 2016-2022 ranged from 49.6 to 51.5 years, 47.6%-48.3% were female. Administrative prevalence ranged from 0.45% in 2016 to 0.53% in 2022. The number of patients initiating advanced treatment ranged from 157 to 347 across the study years (3.2%-4.9% of overall treated study population). On average from 2016-2021, 78.8% had inadequate response in the 12 months following index treatment. Common indicators included prolonged use of corticosteroids (46.2%) and augmentation with conventional therapies (43.9%).</p><p><strong>Conclusions: </strong>Adult ulcerative colitis patients showed a high prevalence of inadequate response to advanced therapies. Our findings reveal a need for improved UC advanced therapy options, providing insight into inadequate response patterns. This may help identify patients who could benefit from a change in therapy to improve long-term outcomes.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Confocal Endomicroscopy Intestinal Epithelial Barrier Abnormalities in Individuals Without Documented Gastro-Intestinal Disease.
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-01-28 DOI: 10.1002/ueg2.12756
Thanh-Hien Trieu, Sophie Vieujean, Nicolas Delhougne, Laurence Seidel, Edouard Louis, Jean-Philippe Loly
{"title":"Confocal Endomicroscopy Intestinal Epithelial Barrier Abnormalities in Individuals Without Documented Gastro-Intestinal Disease.","authors":"Thanh-Hien Trieu, Sophie Vieujean, Nicolas Delhougne, Laurence Seidel, Edouard Louis, Jean-Philippe Loly","doi":"10.1002/ueg2.12756","DOIUrl":"https://doi.org/10.1002/ueg2.12756","url":null,"abstract":"<p><strong>Background and aims: </strong>Probe-based confocal endomicroscopy (pCLE) allows real-time microscopic visualization of the intestinal mucosa surface layers. Despite remission achieved through anti-tumor necrosis factor or vedolizumab therapy, anomalies in the intestinal epithelial barrier are observed in inflammatory bowel disease (IBD) patients. Our study aimed to assess these abnormalities in non-IBD individuals and compare them with IBD patients in endoscopic remission to identify the associated factors.</p><p><strong>Methods: </strong>The study involved 84 patients, 40 with IBD under biologic therapy for over 6 months and in endoscopic remission, and 44 without IBD or irritable bowel syndrome (IBS) undergoing colorectal screening colonoscopy. White light endoscopy and probe-based confocal laser endomicroscopy were performed in the ileum, right colon, transverse colon, left colon, and rectum. Demographic, clinical, biological, and morphological factors were examined.</p><p><strong>Results: </strong>pCLE revealed abnormalities in both non-IBD individuals and those with IBD in endoscopic remission, such as fluorescein leakage, blood vessel dilatation, and hypervascularization across all segments, as well as epithelial gaps in the ileum, and crypt dilatation in the colon. Comparing the two groups, IBD patients exhibited slightly more gaps in the ileum, increased fluorescein leakage in the transverse colon, and fewer vessel dilatation in the transverse colon. Abnormalities were more frequent in cases of hypertension (p = 0.03), dyslipidemia (p = 0.02), female gender (p = 0.02), selective serotonin reuptake inhibitor (p = 0.03), and family history of IBD (p = 0.04) or colorectal cancer (p = 0.03).</p><p><strong>Conclusion: </strong>Confocal endomicroscopy abnormalities are present in both non-IBD individuals undergoing colorectal cancer screening colonoscopy as in those with IBD in endoscopic remission. Further research is needed to understand the pathophysiological mechanisms of these abnormalities and their clinical impact.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Metabolic Dysfunction-Associated Steatotic Liver Disease and Pancreatic Disease-A Population-Based Nationwide Cohort and Sibling-Controlled Study.
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-01-27 DOI: 10.1002/ueg2.12761
Miroslav Vujasinovic, Fahim Ebrahimi, Bjorn Roelstraete, David Bergman, Jiangwei Sun, Omid Sadr-Azodi, J-Matthias Löhr, Jonas F Ludvigsson
{"title":"Metabolic Dysfunction-Associated Steatotic Liver Disease and Pancreatic Disease-A Population-Based Nationwide Cohort and Sibling-Controlled Study.","authors":"Miroslav Vujasinovic, Fahim Ebrahimi, Bjorn Roelstraete, David Bergman, Jiangwei Sun, Omid Sadr-Azodi, J-Matthias Löhr, Jonas F Ludvigsson","doi":"10.1002/ueg2.12761","DOIUrl":"https://doi.org/10.1002/ueg2.12761","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) has been linked to pancreatic diseases, but evidence from population-based studies with liver histology is lacking.</p><p><strong>Aims and methods: </strong>In this population-based cohort including all Swedish adults (n = 8563) with biopsy-proven MASLD, we aimed to investigate incidences of pancreatic diseases compared with matched reference individuals from the general population (n = 38,858) and full siblings (n = 6696). Using Cox proportional hazard models, we calculated multivariable adjusted hazard ratios (aHRs) and confidence intervals (CIs).</p><p><strong>Results: </strong>We documented 359 incidents of pancreatic diseases in MASLD patients and 880 events in matched reference individuals, resulting in an incidence rate difference of 1.54 (95% CI, 1.25-1.84). The relative risk of pancreatic disease was highest in the first two years after MASLD diagnosis (aHR, 2.19 [95% CI, 1.92-2.50), but remained statistically significant increased even up to ten years [aHR, 1.60 (95% CI, 1.38-1.85)]. The most common pancreatic disease in individuals with MASLD was acute non-biliary pancreatitis (1.44 vs. 0.44 events/1000 PY), followed by chronic pancreatitis (0.54 vs. 0.12/1000 PY) and pancreatic cancer (0.88 vs. 0.47/1000 PY). We documented 130 versus 344 pancreas-related deaths among individuals with MASLD and their matched comparators, yielding an absolute risk difference of 0.51/1000 PY and an aHR of 2.41 (95%CI = 1.95-2.97). The findings were consistent in sibling-controlled analyses with an aHR of 2.21 (95%CI = 1.69-2.90).</p><p><strong>Conclusions: </strong>MASLD was associated with significantly higher rates of acute and chronic pancreatitis of predominantly non-biliary origin, as well as an increased risk of pancreatic cancer and pancreas-related mortality.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Artificial Intelligence in Pancreatic Imaging: A Systematic Review.
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-01-26 DOI: 10.1002/ueg2.12723
Nicoleta Podină, Elena Codruța Gheorghe, Alina Constantin, Irina Cazacu, Vlad Croitoru, Cristian Gheorghe, Daniel Vasile Balaban, Mariana Jinga, Cristian George Țieranu, Adrian Săftoiu
{"title":"Artificial Intelligence in Pancreatic Imaging: A Systematic Review.","authors":"Nicoleta Podină, Elena Codruța Gheorghe, Alina Constantin, Irina Cazacu, Vlad Croitoru, Cristian Gheorghe, Daniel Vasile Balaban, Mariana Jinga, Cristian George Țieranu, Adrian Săftoiu","doi":"10.1002/ueg2.12723","DOIUrl":"https://doi.org/10.1002/ueg2.12723","url":null,"abstract":"<p><p>The rising incidence of pancreatic diseases, including acute and chronic pancreatitis and various pancreatic neoplasms, poses a significant global health challenge. Pancreatic ductal adenocarcinoma (PDAC) for example, has a high mortality rate due to late-stage diagnosis and its inaccessible location. Advances in imaging technologies, though improving diagnostic capabilities, still necessitate biopsy confirmation. Artificial intelligence, particularly machine learning and deep learning, has emerged as a revolutionary force in healthcare, enhancing diagnostic precision and personalizing treatment. This narrative review explores Artificial intelligence's role in pancreatic imaging, its technological advancements, clinical applications, and associated challenges. Following the PRISMA-DTA guidelines, a comprehensive search of databases including PubMed, Scopus, and Cochrane Library was conducted, focusing on Artificial intelligence, machine learning, deep learning, and radiomics in pancreatic imaging. Articles involving human subjects, written in English, and published up to March 31, 2024, were included. The review process involved title and abstract screening, followed by full-text review and refinement based on relevance and novelty. Recent Artificial intelligence advancements have shown promise in detecting and diagnosing pancreatic diseases. Deep learning techniques, particularly convolutional neural networks (CNNs), have been effective in detecting and segmenting pancreatic tissues as well as differentiating between benign and malignant lesions. Deep learning algorithms have also been used to predict survival time, recurrence risk, and therapy response in pancreatic cancer patients. Radiomics approaches, extracting quantitative features from imaging modalities such as CT, MRI, and endoscopic ultrasound, have enhanced the accuracy of these deep learning models. Despite the potential of Artificial intelligence in pancreatic imaging, challenges such as legal and ethical considerations, algorithm transparency, and data security remain. This review underscores the transformative potential of Artificial intelligence in enhancing the diagnosis and treatment of pancreatic diseases, ultimately aiming to improve patient outcomes and survival rates.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
CiThroModel Improves Prediction of Symptomatic Venous Thromboembolism in Hospitalized Patients With Cirrhosis Without Hepatocellular Carcinoma.
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-01-23 DOI: 10.1002/ueg2.12758
Alberto Zanetto, Alessandro Vitale, Filippo Pelizzaro, Vittorio Simeon, Elena Campello, Laura Turco, Lorenz Balcar, Francesco Paolo Russo, Patrizia Burra, Paolo Simioni, Marco Senzolo
{"title":"CiThroModel Improves Prediction of Symptomatic Venous Thromboembolism in Hospitalized Patients With Cirrhosis Without Hepatocellular Carcinoma.","authors":"Alberto Zanetto, Alessandro Vitale, Filippo Pelizzaro, Vittorio Simeon, Elena Campello, Laura Turco, Lorenz Balcar, Francesco Paolo Russo, Patrizia Burra, Paolo Simioni, Marco Senzolo","doi":"10.1002/ueg2.12758","DOIUrl":"https://doi.org/10.1002/ueg2.12758","url":null,"abstract":"<p><strong>Background & aims: </strong>Venous thromboembolism (VTE) is a recognized complication of acutely ill patients, but its incidence and risk factors in those with cirrhosis are uncertain.</p><p><strong>Methods: </strong>We retrospectively studied a consecutive cohort of cirrhosis patients non-electively admitted to our medical unit to determine the rates of symptomatic VTE during hospitalization. Firstly, we explored associations with baseline, clinical and laboratory characteristics using logistic regression. Secondly, we developed a clinical prediction model that could predict the risk of in-hospital VTE.</p><p><strong>Results: </strong>We included 687 patients (median age 61 years old; 68% male; Child-Pugh A/B/C, 13%/40%/47%). During hospitalization, 34 patients (4.9%) experienced VTE. Multivariate analysis showed that male sex (OR: 2.56, p = 0.05), AKI (OR: 3.1, p = 0.001), bacterial infections (OR: 2.6, p = 0.008), Pugh score (OR: 1.6. p < 0.001), family history of thrombosis (OR: 3.1, p = 0.04), reduced mobility (OR: 4.6, p < 0.001), and C-reactive protein (OR: 1.1, p = 0.005) were independent predictors of VTE. We combined these variables in a prediction model (CirrhosisThrombosisModel) that accurately discriminated between high- and low-risk patients. The AUROC of CiThroModel was significantly higher than that of Padua prediction score (0.882 vs. 0.742). After validating the CiThroModel using bootstrapping, the adjusted model maintained optimal discrimination ability (0.862) and calibration. The adjusted formula to calculate the in-hospital risk of VTE was -9.00 + 0.82 [Male sex] + 1.14 [AKI] + 0.98 [Infection] + 0.48 * Child Pugh score + 1.14 [VTE family history] + 1.54 [Reduced mobility] + 0.15 * PCR/10.</p><p><strong>Conclusion: </strong>The CiThroModel seems a valuable tool for identifying hospitalized patients with cirrhosis at risk of VTE (https://majinzin.shinyapps.io/vterisk/).</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Completely Right-Sided Sigmoid and Descending Colon in a Rectal Cancer Patient. 完全右侧乙状结肠和降结肠在直肠癌患者中的应用。
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-01-21 DOI: 10.1002/ueg2.12754
Rui Hou, Guole Lin
{"title":"Completely Right-Sided Sigmoid and Descending Colon in a Rectal Cancer Patient.","authors":"Rui Hou, Guole Lin","doi":"10.1002/ueg2.12754","DOIUrl":"https://doi.org/10.1002/ueg2.12754","url":null,"abstract":"","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Inter-Rater Disagreements in Applying the Montreal Classification for Crohn's Disease: The Five-Nations Survey Study. 对克罗恩病应用蒙特利尔分类的评分者之间的分歧:五国调查研究。
IF 5.8 2区 医学
United European Gastroenterology Journal Pub Date : 2025-01-18 DOI: 10.1002/ueg2.12757
Offir Ukashi, Aurelien Amiot, David Laharie, Luis Menchén, Ana Gutiérrez, Samuel Fernandes, Tommaso Pessarelli, Fábio Correia, Carlos Gonzalez-Muñoza, Julia López-Cardona, Giulio Calabrese, Rocio Ferreiro-Iglesias, Natalie Tamir-Degabli, Nikolas Konstantine Dussias, Amjad Mousa, Raquel Oliveira, Nicolas Richard, Ido Veisman, Kassem Sharif, Shomron Ben-Horin, Carlos Soutullo-Castiñeiras, Gabriele Dragoni, Silvia Rotulo, Agnese Favale, Louis Calméjane, Thomas Bazin, Alfonso Elosua, Sara Lopes, Carla Felice, Violeta Mauriz, Inês Coelho Rodrigues, Julia Jougon, Inês Botto, Helena Tavares de Sousa, Lorenzo Bertani, Paula Ripoll Abadía, Alice De Bernardi, Yamile Zabana, Xavier Serra-Ruiz, Anna Viola, Manuel Barreiro-de Acosta, Henit Yanai, Alessandro Armuzzi, Fernando Magro, Uri Kopylov
{"title":"Inter-Rater Disagreements in Applying the Montreal Classification for Crohn's Disease: The Five-Nations Survey Study.","authors":"Offir Ukashi, Aurelien Amiot, David Laharie, Luis Menchén, Ana Gutiérrez, Samuel Fernandes, Tommaso Pessarelli, Fábio Correia, Carlos Gonzalez-Muñoza, Julia López-Cardona, Giulio Calabrese, Rocio Ferreiro-Iglesias, Natalie Tamir-Degabli, Nikolas Konstantine Dussias, Amjad Mousa, Raquel Oliveira, Nicolas Richard, Ido Veisman, Kassem Sharif, Shomron Ben-Horin, Carlos Soutullo-Castiñeiras, Gabriele Dragoni, Silvia Rotulo, Agnese Favale, Louis Calméjane, Thomas Bazin, Alfonso Elosua, Sara Lopes, Carla Felice, Violeta Mauriz, Inês Coelho Rodrigues, Julia Jougon, Inês Botto, Helena Tavares de Sousa, Lorenzo Bertani, Paula Ripoll Abadía, Alice De Bernardi, Yamile Zabana, Xavier Serra-Ruiz, Anna Viola, Manuel Barreiro-de Acosta, Henit Yanai, Alessandro Armuzzi, Fernando Magro, Uri Kopylov","doi":"10.1002/ueg2.12757","DOIUrl":"https://doi.org/10.1002/ueg2.12757","url":null,"abstract":"<p><strong>Background: </strong>The Montreal classification has been widely used in Crohn's disease since 2005 to categorize patients by the age of onset (A), disease location (L), behavior (B), and upper gastrointestinal tract and perianal involvement. With evolving management paradigms in Crohn's disease, we aimed to assess the performance of gastroenterologists in applying the Montreal classification.</p><p><strong>Methods: </strong>An online survey was conducted among participants at an international educational conference on inflammatory bowel diseases. Participants classified 20 theoretical Crohn's disease cases using the Montreal classification. Agreement rates with the inflammatory bowel diseases board (three expert gastroenterologists whose consensus rating was considered the gold standard) were calculated for gastroenterologist specialists and fellows/specialists with ≤ 2 years of clinical experience. A majority vote < 75% among participants was considered a notable disagreement. The same cases were classified using three large language models (LLMs), ChatGPT-4, Claude-3, and Gemini-1.5, and assessed for agreement with the board and gastroenterologists. Fleiss Kappa was used to assess within-group agreement.</p><p><strong>Results: </strong>Thirty-eight participants from five countries completed the survey. In defining the Montreal classification as a whole, specialists (21/38 [55%]) had a higher agreement rate with the board compared to fellows/young specialists (17/38 [45%]) (58% vs. 49%, p = 0.012) and to LLMs (58% vs. 18%, p < 0.001). Disease behavior classification was the most challenging, with 76% agreement among specialists and fellows/young specialists and 48% among LLMs compared to the inflammatory bowel diseases board. Regarding disease behavior, within-group agreement was moderate (specialists: k = 0.522, fellows/young specialists: k = 0.532, LLMs: k = 0.577; p < 0.001 for all). Notable points of disagreement included: defining disease behavior concerning obstructive symptoms, assessing disease extent via video capsule endoscopy, and evaluating treatment-related reversibility of the disease phenotype.</p><p><strong>Conclusions: </strong>There is significant inter-rater disagreement in applying the Montreal classification, particularly for disease behavior in Crohn's disease. Improved education or revisions to phenotype criteria may be needed to enhance consensus on the Montreal classification.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
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