bluuebunny/crossref_metadata_2025_split huggingface dataset:
A109 A COMPARISON OF MULTIMORBIDITY AT DEATH AMONG PERSONS WITH AND WITHOUT INFLAMMATORY BOWEL DISEASE: A POPULATION-BASED STUDY
Authors: Postill G , Tang F , Kuenzig E , Buajitti E , Harish V , Benchimol E I 
Published: February 2024

Abstract

Background
With improved care and life-expectancy, people with IBD are living longer and more likely to develop multiple chronic conditions. However, research on co-morbidities in the IBD population has typically focused on co-occurrences of a specific disease alongside IBD and employed a cross-sectional or short-term cohort perspective. To date, no work has taken a life-course perspective, evaluating retrospectively from death, to identify the population-level burden of multimorbidity.

Aims
To identify the burden of chronic conditions at time of death among people with IBD relative to their non-IBD counterparts.

Methods
We conducted a retrospective matched cohort study using health administrative data from Ontario, Canada. Individuals with IBD (identified using a validated algorithm) who died between 2010 to 2020 were matched to controls (1:5 ratio) based on sex, age at death, and year of death. We calculated the proportion of decedents with each of 17 different chronic conditions and the number of conditions at death. Conditions were identified using validated algorithms or clusters of diagnostic codes (when validated algorithms were not available). The number of chronic conditions at death among people with and without IBD was modeled using Poisson regression adjusting for Ontario Marginalization Index and accounting for matching.

Results
At the time of death, people with IBD (n=9728) were more likely than matched controls (n=42,389) to have mood disorders (69.0% vs. 60.2%), asthma (21.4% vs. 16.5%), renal failure (49.6% vs. 38.5%), osteoarthritis (76.8 vs. 67.6%), and osteoporosis (21.2% vs. 12.8%) (Figure 1B). Compared to their controls, people with IBD had were more likely to have ≥5 conditions (77.8% vs. 70.1%) (Figure 1A). People with IBD had significantly more chronic health conditions (RR 1.11, 95% CI 1.10-1.12).

Conclusions
People with IBD accumulate a greater degree of morbidity compared to those without IBD. Our findings add a novel understanding of multimorbidity among those with IBD from a life-course perspective. Our research highlights the need to provide quality multi-disciplinary care to people with IBD across the life course to address the increased frequency of multimorbidity.

Funding Agencies
ACG
A110 INVOLVING STAKEHOLDERS TO DEVELOP BREASTFEEDING EDUCATIONAL RESOURCES FOR PATIENTS WITH INFLAMMATORY DISEASE
Authors: Rho S , Ferenbok J , Marcon E , Habashi P , Berga K , Bradbury L , Huang V 
Published: February 2024

Abstract

Background
Inflammatory Bowel Disease (IBD) are incurable chronic inflammatory disease of the digestive tract that is often treated with immunosuppressive medications. Common IBD symptoms are frequent bowel movements that may be accompanied by blood, constipation, diarrhea, abdominal cramps and pain, fatigue, unintentional weight loss, and many more. Patients who are or are considering breastfeeding often face concerns and decisions about IBD medications and potential effects on breastfeeding and their breastfed infant, or they may have trouble with breastfeeding due to IBD symptoms. Despite the evident benefits of breastfeeding for infants, the rate of long-term breastfeeding amongst women with IBD is low at 55.2% at 6 months. A preliminary environmental scan revealed that there is a lack of informative educational resources for the population.

Aims
To develop a patient-centric educational resource that provides information and assurance on breastfeeding for a person living with IBD.

Methods
The study involved 4 stages: (1) phase 1 interview to collect perspectives and expertise, (2) prototype development, (3) phase 2 interview to obtain feedback on the prototype, and (4) prototype refinement. Participants included two groups: healthcare providers and IBD patients who have breastfed or are currently breastfeeding. All interviews were conducted remotely. Interview transcripts were coded to analyze the data.

Results
In total of 12 participants (6 healthcare providers and 6 patients) were recruited and completed the study. Through thematic analysis, three main themes were identified: 1) breastfeeding concerns that patients have prior to breastfeeding; 2) breastfeeding issues that patients experience while breastfeeding; 3) education format and content. These themes aided in the development and refinement of the prototype, which included graphics, easily digestible information, references, and short videos. The prototype is a webpage residing in a preconception and pregnancy in IBD website.

Conclusions
By involving the stakeholders, the intervention reflected the needs of patients and the expertise of healthcare providers. The main concern of IBD patients regarding breastfeeding was the IBD medication transfer via breastmilk and safety for breastfed infants. Interestingly, patients preferred to obtain information through short videos rather than the traditional counseling method that healthcare providers offer in clinics. These are included in the intervention. This study method can be applicable to other fields, to ensure that the needs of patients are well represented in patient education resources.

Funding Agencies
University of Toronto
A111 CHARACTERISTICS OF HOSPITALIZED PATIENTS WITH GASTROINTESTINAL DISEASE WHO LEAVE AGAINST MEDICAL ADVICE
Authors: Rivas A , Purdy E , Buhler K , Flemming J , Ma C 
Published: February 2024

Abstract

Background
Hospitalized inpatients who leave against medical advice (AMA) may have incomplete care, resulting in readmission and increased healthcare costs. Limited evidence exists in patients diagnosed with a primary gastrointestinal (GI) disease who leave AMA. Identifying patients with GI diagnoses who leave AMA may inform risk stratification to determine which patients are at risk of unplanned discharge.

Aims
Identify characteristics in patients diagnosed with GI diseases who leave AMA.

Methods
A retrospective evaluation was conducted using the National Inpatient Sample (NIS) from 2016 to 2020. The NIS provides national-level estimates of cost, quality, and outcomes from hospitalizations in the United States. We used International Classification of Diseases, Tenth Revision diagnostic coding to identify patients admitted with a primary GI problem. The proportion of patients who left AMA for each diagnosis was determined (Figure 1). A multivariable logistic regression was performed to determine factors associated with an AMA discharge, adjusting for age, sex, elective or weekend admission, primary payment method, race, hospital setting, geography, income, Elixhauser comorbidity index, alcohol and/or drug abuse and depression status.

Results
Between 2016 and 2020, 1.61% of patients with a GI primary problem left the hospital AMA. Characteristics associated with leaving AMA included: older age, female sex, non-white race, rural hospital admission, higher income and having comorbid conditions (Table 1). Patients with a history of alcohol abuse were more likely to leave AMA, while patients with a history of drug abuse were less likely to leave AMA.

Conclusions
Approximately 1 in 60 patients admitted with a primary GI problem leave hospital AMA and we identify both structural and patient-level factors associated with unplanned discharge.
Table 1: Factors Associated With AMA Discharge For GI-related Diagnoses

Funding Agencies
None
A116 PREVALENCE OF EDITORIAL BOARD MEMBERSHIP AMONG ORIGINAL RESEARCH PUBLISHED IN HIGH IMPACT GASTROENTEROLOGY-FOCUSED JOURNALS: A CROSS-SECTIONAL ANALYSIS
Authors: Verma Y , Scaffidi M , Gimpaya N , Li A , Khan R , Grover S C 
Published: February 2024

Abstract

Background
Editorial board members, as experts in their field, often publish relevant research in journals on which they serve. This combined role of “editor-as-author” may be a source for conflict of interest in the peer review process. In Gastroenterology-focused journals, the prevalence of instances for editor-as-author has not been explored.

Aims
To estimate the prevalence of editor-as-author among high impact factor (IF) Gastroenterology-focused journals.

Methods
We used a cross-sectional study design. We used InCites Journal reports to identify 30 Gastroenterology journals with the highest IF in 2020, wherein we included journals that had publicly accessible board membership that indicated the following: institution/city/country; and at least the first name initial and entire last name for editorial board members. We created a list of all editorial board members, excluding any emeritus editors and society representatives. Among these journals, we identified all original research articles using the Web of Science, wherein we excluded any editorial material, meeting abstracts, and clinical practice guidelines. Among these original publications, two authors then independently and in duplicate determined any instances of authors who had editorial board membership. The primary outcome measure was the prevalence of editors-as-authors. Secondary outcomes involved the number of editorial board members with first authorships and senior/corresponding authorships, as well as the number of articles that disclosed editorial board membership.

Results
Among the 30 Gastroenterology-focused journals that had the highest IF, 24 met the relevant inclusion criteria. These journals had a total of 6162 original publications, of which 992 (16.1%) had at least one instance of editor-as-author; 8 (0.1%) articles disclosed that there was editorial board membership among its authors. Among all 24 included journals, there were a total 2106 editorial board members. Of these members, 635 (30.2%) had at least one instance of editor-as-author, wherein 134 and 263 members were first authors and senior/corresponding authors, respectively.

Conclusions
Our study found that approximately one third of editorial board members among high IF Gastroenterology-focused journals were also authors in these same journals. Future analysis will focus on determining whether there is the difference in quality of published work compared to those without editorial board membership.

Funding Agencies
None
A117 WORK PRODUCTIVITY IMPAIRMENT IN PERSONS WITH INFLAMMATORY BOWEL DISEASES: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Youssef M , Hossein-Javaheri N , Hoxha T , Mallouk C , Tandon P 
Published: February 2024

Abstract

Background
Inflammatory bowel diseases (IBD), which include Crohn’s disease (CD) and ulcerative colitis (UC), are chronic disorders that affect approximately 6.8 million people globally. IBD often develops at an early age and can have a significant impact on employment outcomes and work productivity. Individuals with IBD have higher rates of unemployment, sick leave, and work disability compared to the general population. Nevertheless, there remains a paucity of standardized reporting on work productivity impairment and the associated indirect costs in patients with IBD.

Aims
In this systematic review and meta-analysis, we evaluate work-related outcomes and employment data among patients with IBD. This may inform clinical and policy decisions to facilitate workplace accomodations for patients with IBD and improve their work productivity.

Methods
A systematic literature search was conducted in MEDLINE, EMBASE, and the Cochrane library, in addition to Scopus, ProQuest, and clinicaltrials.gov from inception to February 2023. We included full-texts and abstracts of observational and clinical trials that reported work-related outcomes in patients with IBD aged ampersand:003E18 years. We collected work-related data as described by the Work Productivity and Activity Impairment (WPAI) tool, in addition to other outcomes including employment, sick leaves, disability pensions, and indirect costs due to productivity loss. Pooled effect analysis was conducted using a random-effects model for pooled estimates of continuous and proportional data with 95% confidence intervals (CIs). Odds ratios (ORs) and mean differences were used to compare data between patients with active disease vs. remission.

Results
We included 134 studies (96 full-text articles and 38 abstracts). Among all patients with IBD, the pooled estimates were 16.41% [13.89-18.93] for absenteeism, 35.91% [31.11-40.72] for presenteeism, 39.41% [33.93-44.88] for overall productivity loss, and 45.96% [39.46-52.46] for non-work related activity impairment. Indirect costs were estimated at 1,813.9, 3,562.49, and 5,131.09 euros/patient/year for absenteeism, presenteeism, and overall work impairment respectively. For other non-WPAI outcomes, the pooled estimate for employment was 65.6%, 39.5% of patients reported sick days, 21.3% reported disability at work due to IBD directly, 12.3% received disability pensions, and 29.6% had lost jobs due to IBD. Overall, patients with active disease had worse WPAI and employment outcomes than those in remission.

Conclusions
IBD may result in significant work productivity impairment, lower employment, and significant indirect costs due to productivity loss. Larger studies with standardized definitions for work outcomes are needed to better evaluate the impact of IBD on work productivity.

Funding Agencies
Mount Sinai Resident Research Funding
A124 A SYSTEMATIC REVIEW OF THE EFFICACY OF ARTIFICIAL INTELLIGENCE IN IDENTIFYING BARRETT'S ESOPHAGUS NEOPLASIA
Authors: Buttar J , Kim H , Byrne M 
Published: February 2024

Abstract

Background
Barrett’s Esophagus (BE) is a known precursor for esophageal adenocarcinoma and requires frequent surveillance with esophagogastroduodenoscopy. Due to tumour heterogeneity and logistical demands on endoscopists, identification of BE dysplasia is difficult and random biopsies are riddled with sampling error. Artificial Intelligence (AI), in the form of computer-aided detection, has entered the endoscopic realm to improve BE dysplasia detection. This systematic review aims to evaluate its efficacy in BE screening.

Aims
To survey the literature regarding the efficacy of machine learning tools in identifying BE dysplasia. The primary outcome was recognition of BE from a database of endoscopic images with histopathologic correlation utilizing a machine learning algorithm, with sensitivity and specificity reported.

Methods
Using the PRISMA framework, MEDLINE, EMBASE and Compendex databases were searched from inception to Sept 1, 2023. Of 1915 articles identified, 35 were selected for full-text review. Two reviewers, JB and JK, independently completed the literature review and discrepancies were reviewed by the PI. After applying inclusion and exclusion criteria, 20 studies were included in the systematic review. The quality of studies was assessed using the Newcastle-Ottawa Scale.
Inclusion Criteria:
-Must include Barrett's esophagus and / or EAC (esophageal adenocarcinoma)
-Must include novel research (not a systematic review or MA)
-Requires use of endoscopic images
-English only, full text manuscripts
Exclusion Criteria:
-No prior surgery (esophagectomy)
-Does not include esophageal squamous cell carcinoma

Results
Of the 20 articles selected, seven were published after 2021. All studies utilized a machine learning algorithm to aid in identification of BE dysplasia. Various imaging modalities were used, including white light imaging, narrow-band imaging, or volumetric laser endomicroscopy. A total of 3,886 patients were included with 5,605 images. Sensitivity ranged from 72 – 100%, specificity ranged from 64 – 94%. The overall quality of studies included was low.

Conclusions
Surveillance of BE dysplasia remains a difficult and time-intensive task. Computer-aided detection of BE dysplasia demonstrates strong performance independent of the machine learning algorithm or imaging modality. Meta-analyses are required to illustrate heterogeneity and power to bolster these preliminary findings.

Funding Agencies
None
A126 IMPACT OF TIME OF DAY ON PROCEDURAL OUTCOMES IN ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP): ANALYSIS FROM A TERTIARY REFERRAL CENTER
Authors: Deeb M , Sabrie N , Khalaf K , Calo N , Mosko J , Forbes N , Grover S 
Published: February 2024

Abstract

Background
Endoscopic retrograde cholangiopancreatography (ERCP) is an established diagnostic and therapeutic tool for hepatobiliary disease. Given its technical demands, it remains one of the highest-risk endoscopic procedures. Addressing modifiable factors, such as operator fatigue, may mitigate procedural risk. In colonoscopy, there is conflicting data on whether procedure time of day, as a surrogate of operator fatigue, affects outcomes, with some literature demonstrating decreased procedure completion and polyp detection rates in the afternoon. There is a paucity of data evaluating this potential relationship in ERCP.

Aims
To evaluate the impact of procedure time of day on procedural success and short-term adverse outcomes in patients undergoing ERCP.

Methods
A retrospective review of ERCP's performed on adult patients at our tertiary referral center from January 1, 2011 to December 31, 2020 was performed. The primary outcome was the procedural success rate, defined as successful navigation to the papilla, selective duct cannulation and cholangiography, and realization of the intended therapeutic goals. Secondary outcomes included procedure duration, rate of deep ductal cannulation, rate of sphincterotomy, and short-term (30-day) adverse events (immediate bleeding, delayed bleeding, pancreatitis, perforation). Statistical analysis was conducted using R. Categorical variables were compared using the Chi-square test of independence or Fisher’s exact test. Continuous variables were compared using T-tests or the Mann-Whitney-U test.

Results
A total of 5755 ERCP’s were performed between 8 AM – 6 PM; 2863 were performed before 12PM (AM group) and 2892 after 12PM (PM group). Baseline characteristics were similar between the two cohorts, with the exception of hypertension (33.7% AM vs 30.1% PM; p=0.003), and anticoagulation (20.3% AM vs 18.3% PM; p=0.05). In both groups, the most common ERCP indication was choledocholithiasis. The primary operators in both cohorts were clinical fellows. There was no difference in procedural success rate (87.0 % AM vs 86.7% PM; p = 0.72), procedure duration (33.6 minutes AM vs 32.9 minutes PM; p = 0.29), rates of deep cannulation (82.6% AM vs 83.0% PM; p = 0.81) and sphincterotomies (63.2% vs 62.7%; p = 0.68). Rate of adverse events were similar, with slightly higher rates of immediate bleeding in the AM group (5.0% AM vs 3.8% PM; p = 0.03). Results were similar in a subgroup analysis of patients with altered anatomy.

Conclusions
In this large retrospective review of ERCPs performed at a tertiary referral center, the procedure time of day did not impact procedural success rate. There were slightly higher rates of immediate bleeding in the AM group, though this may be explained by higher rates of anticoagulation in that group.

Funding Agencies
None
A127 ENDOSCOPIC MUCOSAL RESECTION WITH HYBRID-ARGON PLASMA ABLATION TO PREVENT RECURRENCE OF 20 MM NON-PEDUNCULATED COLORECTAL POLYPS: A MULTI-CENTER PROSPECTIVE CLINICAL STUDY
Authors: Djinbachian R , Levenick J M , Bouchard S , Moyer M T , Deslandres E , Mosko J , Teshima C , Shahidi N , von Renteln D 
Published: February 2024

Abstract

Background
Endoscopic mucosal resection (EMR) is the mainstay of therapy for non-pedunculated colorectal polyps 20 mm or larger. Post EMR recurrence rates are about 15% if no margin ablation technique is used.

Aims
Study aim was to evaluate recurrence rates if hybrid Argon Plasma Coagulation ablation (h-APC) is routinely used after the EMR to ablate the margins, base and vessels.

Methods
A prospective multi-center study including adult patients (18-89 years) undergoing EMR of non-pedunculated colorectal polyps 20 mm or larger was conducted. h-APC was used to ablate all post EMR margins and to ablate the post EMR resection surface and visible submucosal vessels. The primary outcome was the biopsy proven recurrence rate at the first follow-up colonoscopy (4-6 months after EMR). All the resection sites were visually inspected, and biopsies were obtained from the EMR scar. Secondary outcomes included technical success and complication rates.

Results
A total of 220 EMRs were performed during the study for h-APC ablation of non-pedunculated colorectal polyps, with a size of ≥20 mm. The average size of the polyps included in the study was 35.7 mm (ranging from 20 mm to 100 mm). Among all resected polyps, 16.8% were sessile serrated lesions (SSL), while 66.3% were adenomas. Additionally, 4 cases of cancer were in the study. The application of hot snare EMR with h-APC ablation was technically successful and completed for all cases. The mean duration of the EMR procedure was 19.6 minutes, ranging from 2.3 to 103 minutes, while the mean duration of h-APC ablation was 6.4 minutes, ranging from 1 to 65 minutes.
A total of 147 EMRs with follow up examination (57 EMR involving lesions 40mm or larger) are available currently. The overall recurrence rate was 1.3% (2 out of 147 cases). For cases where complete base ablation was achieved, there was a 0% recurrence rate, including lesions 40mm or larger. For lesions measuring 40mm or larger, the recurrence rate was 1.8% (1 out of 54 cases). Out of the 220 total EMRs conducted, perforations were observed in 0.9% (2 cases, managed conservatively with antibiotics only), and clinically significant bleeding occurred in 2.3% (5 cases). In particular, clinically significant bleeding was noted in 2.3% (4 out of 167 cases) of lesions without clipping and in 4.0% (4 out of 99 cases) for right-sided lesions without clipping.

Conclusions
In this multicenter study EMR in combination with h-APC demonstrated a high technical success rate with low complication rates and showed very low post EMR recurrence in the preliminary data analysis.

Funding Agencies
Erbe