Jarrad Wilson

High incidence of inflammatory bowel disease in Australia: A prospective population-based Australian incidence study

Background: To date, there have been no population‐based epidemiological studies published from Australia concerning the incidence of inflammatory bowel disease (IBD). Our hypothesis was that the incidence of IBD in Australia is at least as high as other industrialized countries, given similar genetic and environmental risk factors. Methods: A prospective, population‐based IBD incidence study was conducted between April 2007 and March 2008 in Greater Geelong, Victoria, Australia. According to 2006 Australian Census data, this comprises an at‐risk population of 259,015. Cases were ascertained from multiple overlapping sources. All local general practitioners, gastroenterologists, surgeons, and pediatricians were contacted every 2 months to identify new IBD cases. The Royal Childrens Hospital in Melbourne, local endoscopy and pathology centers were also searched to ensure completeness of case capture. Standard IBD case definitions were used with clinical, endoscopic, and histological criteria. Results: In all, 76 new cases of IBD were identified during the 1‐year period. There were 45 cases of Crohns disease, 29 of ulcerative colitis, and 2 of indeterminate colitis. The crude annual incidence rates for IBD overall, Crohns disease, ulcerative colitis, and indeterminate colitis were 29.3 per 100,000 (95% confidence interval [CI] 23.5–36.7 per 100,000), 17.4 per 100,000, 11.2 per 100,000, and 0.8 per 100,000, respectively. When directly age‐standardized to the World Health Organization standard population the overall IBD incidence rate was 29.6 per 100,000. Conclusions: This is the first prospective, Australian population‐based IBD incidence study. The incidence rates are among the highest reported in the literature of IBD. (Inflamm Bowel Dis 2009)

Preliminary examination of the relations between disease activity, illness perceptions, coping strategies, and psychological morbidity in Crohn's disease guided by the common sense model of illness

Background: An individuals psychological adjustment to illness is influenced by disease severity, illness perceptions, and coping strategies. A more precise understanding of the contribution of each of these factors to a patients well‐being may influence the kind of psychological support required by patients. This study therefore aimed to characterize the contributors to psychological well‐being in patients with Crohns disease (CD). The design was a cross‐sectional questionnaire‐based study. Methods: Ninety‐six CD patients (34 males, 62 females, mean age 38 years) attending a tertiary hospital inflammatory bowel disease outpatient clinic were studied. Disease severity was evaluated according to the Crohns Disease Activity Index (CDAI), coping styles assessed with the Carver Brief COPE scale, illness perceptions explored with the Brief Illness Perceptions Questionnaire (BIPQ), and anxiety and depression measured using the Hospital Anxiety and Depression Scale (HADS). Results: Combining the questionnaire data using structural equation modeling resulted in a final model with an excellent fit (χ2 (7) = 10.42, P = 0.17, χ2/N = 1.49, root mean square error of approximation (RMSEA) < 0.07, comparative fit index (CFI) > 0.97, Goodness‐of‐fit index (GFI) > 0.97). Disease activity had a significant direct influence on illness perceptions (&bgr; = 51, P < 0.001). In turn, illness perceptions had a significant direct influence on depression and anxiety (&bgr; = 41, P < 0.001, &bgr; = 0.40, P < 0.001, respectively). Use of emotional coping strategies was associated significantly (P < 0.001) with the presence of anxiety and depression. Conclusions: There is an interrelationship between disease activity, illness perceptions, coping strategies, and depression and anxiety. These aspects of psychological processing provide a framework and direction for the psychological support that patients with CD require.

Diagnosis of solid pancreatic masses by endoscopic ultrasound-guided fine-needle aspiration.

Background:  Endoscopic ultrasound (EUS) with fine‐needle aspiration (FNA) is increasingly being used in the staging algorithm for pancreatic carcinoma. This allows for a tissue diagnosis, which was previously difficult to obtain. The aim of this study is to assess the utility of EUS–FNA in establishing the diagnosis of solid pancreatic mass lesions in an Australian population.

Prospective population‐based cohort of inflammatory bowel disease in the biologics era: Disease course and predictors of severity

We have previously found high incidence of inflammatory bowel disease (IBD) in Australia. A population‐based registry was established to assess disease severity, frequency of complications, and prognostic factors.

Influence of food and lifestyle on the risk of developing inflammatory bowel disease.

The Barwon area in Australia has one of the highest incidence rates of inflammatory bowel disease (IBD) and therefore is an ideal location to study the impact of environmental exposures on the diseases development.

Never underestimate inflammatory bowel disease: High prevalence rates and confirmation of high incidence rates in Australia

Regional variations in inflammatory bowel disease (IBD) rates have been observed. Limited epidemiological data are available from Australasia. IBD prevalence rates have never been assessed in an Australian population‐based setting. In addition, there are few historical IBD incidence data to allow assessment of rate changes. The aims were to calculate Australias first population‐based IBD prevalence rates, to reassess local IBD incidence rates, and to establish a population‐based inception cohort.

Health Care Cost Analysis in a Population-based Inception Cohort of Inflammatory Bowel Disease Patients in the First Year of Diagnosis

BACKGROUND There are limited prospective population-based data on the health care cost of IBD in the post-biologicals era. A prospective registry that included all incident cases of inflammatory bowel disease [IBD] was established to study disease progress and health cost. AIM To prospectively assess health care costs in the first year of diagnosis among a well-characterised cohort of newly diagnosed IBD patients. METHOD Incident cases of IBD were prospectively identified in 2007-2008 and 2010-2013 from multiple health care providers, and enrolled into the population-based registry. Health care resource utilisation for each patient was collected through active surveillance of case notes and investigations including specialist visits, diagnostic tests, medications, medical hospitalisation, and surgery. RESULTS Off 276 incident cases of IBD, 252 [91%] were recruited to the registry, and health care cost was calculated for 242 (146 Crohns disease [CD] and 96 ulcerative colitis [UC] patients). The median cost in CD was higher at A

Endoscopic ultrasound of pancreatic cystic lesions.

5905 per patient (interquartile range [IQR]: A

Su1312 The First Prospective Australian Population-Based Study of Newly Diagnosed IBD Identifies Frequent Use of Immunomodulators, Low Surgery Rates and High Cost From Medications and Investigations

1571-

P621 The natural history of inflammatory bowel disease (IBD) in an Australian based community cohort: investigating predictors of severe disease and risk of complications

91,324) than in UC at A