The Current State of Care for Black and Hispanic Inflammatory Bowel Disease Patients

Liu, Julia J.; Abraham, Bincy; Adamson, Paula; Barnes, Edward L.; Brister, Kelly; Damas, Oriana M.; Glover, Sarah C.; Hooks, Kimberly; Ingram, Ana; Kaplan, Gilaad G.; Loftus, Edward V.; McGovern, Dermot; Narain-Blackwell, Melodie; Odufalu, Florence-Damilola; Quezada, Sandra; Reeves, Vonda; Shen, Bo; Stappenbeck, Thaddeus S; Ward, Latonia

doi:10.1093/ibd/izac124

Cited by 9 publications

(9 citation statements)

References 114 publications

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“…Barriers to care, such as lengthy wait times and inaccessibility to a dietician or IBD specialist, are even more pronounced in patients of minority backgrounds, which can further exaggerate disparities and lead to delays in diagnosis and treatment. (30) LLMs may empower these patients with knowledge regarding their disease, giving them a tool which helps them proactively engage with their healthcare providers. LLMs may also prove beneficial to patients who have language discordance with their healthcare providers, given disparities in healthcare outcomes based on language preference have been previously shown.…”

Section: Discussionmentioning

confidence: 99%

Artificial Intelligence and Patient Education: Examining the Accuracy and Reproducibility of Responses to Nutrition Questions Related to Inflammatory Bowel Disease by GPT-4

Samaan,

Issokson,

Feldman

et al. 2023

Preprint

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Background and AimsGenerative Pre-trained Transformer-4 (GPT-4) is a large language model (LLM) trained on a variety of topics, including the medical literature. Nutrition plays a critical role in managing inflammatory bowel disease (IBD), with an unmet need for nutrition-related patient education resources. The aim of this study is to examine the accuracy and reproducibility of responses by GPT-4 to patient nutrition questions related to IBD.MethodsQuestions were curated from adult IBD clinic visits, Facebook, and Reddit. Two IBD-focused registered dieticians independently graded the accuracy and reproducibility of GPT-4’s responses while a third senior IBD-focused registered dietitian arbitrated. To ascertain reproducibility, each question was inputted twice into the model. Descriptive analysis is presented as counts and proportions.ResultsIn total, 88 questions were included. The model provided correct responses to 73/88 questions (83.0%), with 61 (69.0%) graded as comprehensive. A total of 15/88 (17%) responses were graded as mixed with correct and incorrect/outdated data. When examined by category, the model provided comprehensive responses to 10 (62.5%) questions related to “Nutrition and diet needs for surgery”, 12 (92.3%) “Tube feeding and parenteral nutrition”, 11 (64.7%) “General diet questions”, 10 (50%) “Diet for reducing symptoms/inflammation” and 18 (81.8%) “Micronutrients/supplementation needs”. The model provided reproducible responses to 81/88 (92.0%) questions.ConclusionGPT-4 provided comprehensive responses to the majority of questions, demonstrating the promising potential of LLMs as supplementary tools for IBD patients seeking nutrition-related information. However, 17% of responses contained incorrect information, highlighting the need for continuous refinement and validation of LLMs prior to incorporation into clinical practice. Future studies should focus on leveraging LLMs to enhance patient outcomes. Furthermore, efforts promoting patient and healthcare professional proficiency in using LLMs are essential to maximize their efficacy and facilitate personalized care.

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Section: Discussionmentioning

confidence: 99%

Artificial Intelligence and Patient Education: Examining the Accuracy and Reproducibility of Responses to Nutrition Questions Related to Inflammatory Bowel Disease by GPT-4

Samaan,

Issokson,

Feldman

et al. 2023

Preprint

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“…Though IBD has historically been associated with patients of European ancestry, recent studies have shown that the incidence of IBD is increasing in other populations as well (20). Studies have also shown a difference in clinical presentation between races, particularly between Hispanic and non-Hispanic White patients.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Intestinal Obstruction in Hospitalized Patients with Inflammatory Bowel Disease: A Retrospective Analysis

Iqbal,

Sohal,

Singh

et al. 2023

Preprint

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Background Inflammatory bowel disease (IBD) is a complex condition that has a variety of gastrointestinal (GI) and extra-intestinal manifestations (EIM). IBD consists of Crohn’s disease (CD) and ulcerative colitis (UC), both of which can lead to several complications including abscess, fistula formation, bleeding, obstruction, and malignancy. Bowel obstruction is associated with significant morbidity, mortality, and healthcare burden. Our study aims to assess predictors of developing intestinal obstruction in hospitalized patients with IBD. Methods Patients with a diagnosis of IBD were identified using the Nationwide Inpatient Sample (NIS) 2016-2020. IBD patients were identified using ICD-10 codes. Patients <18 years and with a diagnosis of both UC and CD were excluded. Patients were stratified based on the presence of intestinal obstruction during hospitalization. Data were collected regarding age, gender, race, primary insurance, median income, hospital region, hospital bed size, and comorbidities. Other variables included presence of fistula, abscess, bleed, colorectal cancer (CRC), diverticulitis, and Clostridium difficile infection (CDI). The association between variables and primary outcome of intestinal obstruction was evaluated using multivariate regression analysis. Results A total of 1,517,485 patients with IBD were included in the final analysis. Among these, 10.1% had intestinal obstruction. The patients with IBD and intestinal obstruction were younger, 18-44 yrs (40.3%), female (51.3%), White (80.3%) and had Medicare insurance (32.5%). After adjusting for confounding factors, fistula (aOR 1.19, p< 0.001, CRC (aOR 2.94, P < 0.001), and tobacco use (aOR 1.09, P < 0.001) had higher odds of developing intestinal obstruction during hospitalization. Patients with abscess (aOR 0.91, P = 0.04), bleeding (aOR 0.22, P < 0.001), Hispanic race (aOR 0.86, P < 0.001), and female sex (aOR 0.76, P < 0.001) had lower odds of developing obstruction. Conclusion Our study found factors associated with higher and lower odds of developing bowel obstruction. Disparities were noted based on race and gender regarding the odds of developing obstruction. Further studies are needed to elucidate the mechanisms driving these findings.

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“…11 Access to care, disease assessment, clinical trial enrollment, and evaluation of environmental factors have all been prioritized for future research in this population. 12…”

Section: Background: Racial Inequities In Inflammatory Bowel Disease ...mentioning

confidence: 99%

“…11 Access to care, disease assessment, clinical trial enrollment, and evaluation of environmental factors have all been prioritized for future research in this population. 12 It is estimated that a large percentage of patients with IBD will require surgery in their lifetime; 15.2% of patients with ulcerative colitis and 47% of patients with Crohn's disease will require intestinal surgery within 10 years of diagnosis. 13,14 Following IBD surgery, NHB patients have been associated with more complicated postoperative recoveries as illustrated by longer lengths of stay, higher readmission rates, and higher odds of death or serious morbidity.…”

Section: Background: Racial Inequities In Inflammatory Bowel Disease ...mentioning

confidence: 99%

Achieving Health Equity: Advancing Colorectal Surgery among Racial and Ethnic Minorities in America

Overstreet,

Hollis

2024

Clin Colon Rectal Surg

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Racial inequities in short and long-term outcomes following colorectal surgery continue to persist. Using inflammatory bowel disease and colorectal cancer as disease foci, we review existing racial inequities in surgical outcomes and complications, discuss how social determinants of health and biopsychosocial factors can contribute to these inequities, and highlight potential mechanisms for building interventions to achieve health equity following colorectal surgery for minority populations.

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The Current State of Care for Black and Hispanic Inflammatory Bowel Disease Patients

Cited by 9 publications

References 114 publications

Artificial Intelligence and Patient Education: Examining the Accuracy and Reproducibility of Responses to Nutrition Questions Related to Inflammatory Bowel Disease by GPT-4

Artificial Intelligence and Patient Education: Examining the Accuracy and Reproducibility of Responses to Nutrition Questions Related to Inflammatory Bowel Disease by GPT-4

Predictors of Intestinal Obstruction in Hospitalized Patients with Inflammatory Bowel Disease: A Retrospective Analysis

Achieving Health Equity: Advancing Colorectal Surgery among Racial and Ethnic Minorities in America

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