Øistein Hovde

• Maseng, Maria Gjerstad; Hansen, Simen Hyll; Grännö, Olle; Bang, Corinna; Lund, Charlotte & Huppertz-Hauss, Gert [Vis alle 22 forfattere av denne artikkelen] (2026). Disentangling the gut microbiome and inflammation in inflammatory bowel diseases: longitudinal observations from the IBSEN III study. Inflammatory Bowel Diseases. ISSN 1078-0998. doi: 10.1093/ibd/izag051. Fulltekst i vitenarkiv Vis sammendrag

  Background and Aim Despite the well-established involvement of the gut microbiome in inflammatory bowel disease (IBD), less is known about how the gut microbiome changes over time and how it varies with clinical disease activity and fecal calprotectin (f-calprotectin). To address this gap, we utilized samples from the population-based inception cohort of the Inflammatory Bowel Disease in South-Eastern Norway III (IBSEN III) study. Methods Data and stool samples from study participants with IBD and symptomatic controls were collected at diagnosis and after 3, 6, and 12 months. Microbiome profiling of stool samples was performed targeting the V3-V4 region of the 16S rRNA gene, and a consensus-based approach of mixed models was employed for the longitudinal microbiome analysis. Results We included 1251 samples from 744 patients with ulcerative colitis, 618 samples from 356 patients with Crohn’ s disease and 266 samples from 164 symptomatic non-IBD controls. In the IBD population, we observed that levels of f-calprotectin decreased over time, as did the patient-reported disease activity (P < .001). Distinct changes in the gut microbiome of IBD patients were observed throughout the first year, such as increased alpha diversity (P < .001) and significant taxonomic changes. Notably, there was no covariation between the changes in alpha diversity and f-calprotectin or symptom score. Conclusion The gut microbiome during the first year after IBD diagnosis showed changes that paralleled inflammation and clinical disease activity, albeit without covariation, suggesting that there may be a disease-driving impact of gut microbiome independent of inflammation and inflammation-driven symptoms.

• Johansen, Ingunn; Hagen, Milada; Løkkeberg, Stine Eileen Torp; Aabrekk, Tone Bergene; Asak, Øyvind & Bengtson, May-Bente [Vis alle 22 forfattere av denne artikkelen] (2026). Anxiety and depression in newly diagnosed patients with inflammatory bowel disease (the IBSEN III study) compared with the general population in Norway. Journal of Crohn's and Colitis. ISSN 1873-9946. 20(3). doi: 10.1093/ecco-jcc/jjag021. Fulltekst i vitenarkiv Vis sammendrag

  Background and Aims: Symptoms of anxiety and depression are common in inflammatory bowel disease (IBD); the aim of this study was to assess the proportion of anxiety and depression in patients newly diagnosed with IBD, compare the rates with the Norwegian general population (NGP), and examine associations with selected sociodemographic, psychological, and disease-related factors. Methods: This prospective cohort study included newly diagnosed patients with IBD, and data from the HUNT4 survey of the NGP. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Crude statistical comparisons were performed using t-tests, Mann–Whitney U test, chi-square tests, or Fisher’s exact tests. Adjusted associations were modeled using multiple robust linear regression and multiple logistic regression. Results: In total, 938/1562 (62.1%) patients with IBD completed the Hospital Anxiety and Depression Scale (Crohn’s disease [CD]: n = 297, ulcerative colitis [UC]: n = 641). The proportion of anxiety was 37.4% in CD and 32.1% in UC, while depression was reported by 21.9% and 16.8%, respectively. Both rates were significantly higher than those observed in the NGP (17.5% for anxiety and 9.4% for depression). Compared with the NGP, males with CD had significantly higher levels of anxiety and depression, males with UC had elevated anxiety only, while females with CD and UC showed increased anxiety and depression. Both substantial fatigue and general self-efficacy were significantly associated with anxiety and depression in IBD. Conclusions: Newly diagnosed patients with IBD experienced significant psychological challenges compared with the NGP. Early identification of anxiety and depression may enable targeted interventions.

• Holten, Kristina Ingeborg Aass; Bernklev, Tomm; Opheim, Randi; Olsen, Bjørn Christian Elias Grova; Johansen, Ingunn & Strande, Vibeke [Vis alle 19 forfattere av denne artikkelen] (2026). Fatigue Trajectory During the First Year of an Inflammatory Bowel Disease Diagnosis, Results from the IBSEN III study. Digestive Diseases and Sciences. ISSN 0163-2116. 71, s. 2476–2487. doi: 10.1007/s10620-025-09661-0. Fulltekst i vitenarkiv Vis sammendrag

  Background: Fatigue is common in Crohn's disease (CD) and ulcerative colitis (UC), but the pathogenesis remains poorly understood. Aims: This study aimed to assess changes in fatigue prevalence during the first year after diagnosis and examine the association between disease course and substantial fatigue (SF) at the 1-year follow-up. Methods: Adults with newly diagnosed CD or UC were recruited from the population-based IBSEN III cohort. Fatigue was assessed at diagnosis and the 1-year follow-up using the Fatigue Questionnaire. Associations between SF at the 1-year follow-up and disease-related factors were quantified using multivariate logistic regression adjusted for sex, age and comorbidities. Results: In total, 596 patients were included (CD: 196, UC: 400). SF was present at both baseline and after one year of disease for 46.9% (n = 92/196) and 40.5% (n = 162/400) of patients with CD and UC, respectively. In CD, development of endoscopically non-passable stricture and/or surgically treated stricture within first year of disease (OR = 4.52, 95%CI [1.61;12.68]), self-reported flares since diagnosis (OR = 2.55, 95%CI [1.26;5.16]), female sex (OR = 3.12, 95%CI [1.53;6.37]) and comorbidities (OR = 4.05, 95%CI [1.89;8.69]) were independently associated with SF at the 1-year follow-up. In UC, SF was associated with current biological treatment (OR = 5.14, 95%CI [1.56;16.96]), increasing Mayo endoscopic score at the 1-year follow-up (OR = 1.54, 95%CI [1.01;2.35]), self-reported flares since diagnosis (OR = 2.66, 95%CI [1.24;5.72]) and female sex (OR = 2.20, 95%CI [1.06;4.57]). Conclusions: Fatigue frequently persists through the first year after IBD diagnosis. Clinical factors reflecting a more severe disease course were associated with SF one year after diagnosis in both CD and UC.

• Zerouga, Insaf; Valeur, Jørgen; Sommer, Christine; Carlsen, Monica Hauger; Hagen, Milada & Høivik, Marte Lie [Vis alle 22 forfattere av denne artikkelen] (2025). Habitual Intake of Macronutrients and Fermentable Oligo-, Di-, Monosaccharides and Polyols is not associated with Irritable Bowel Syndrome-like Symptoms in Inflammatory Bowel Disease. Clinical Nutrition ESPEN. ISSN 2405-4577. 67, s. 105–113. doi: 10.1016/j.clnesp.2025.03.005. Fulltekst i vitenarkiv
• Strande, Vibeke; Hagen, Milada; Lund, Charlotte; Asak, Øivind Wessel; Bengtson, May-Bente & Cetinkaya, Raziye Boyar [Vis alle 26 forfattere av denne artikkelen] (2025). Predicting severe inflammatory bowel disease: a risk matrix model based on the IBSEN III inception cohort. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 60(7), s. 716–727. doi: 10.1080/00365521.2025.2512591. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims: Identifying patients at risk of developing severe inflammatory bowel disease (IBD) can aid treatment decisions. However, predicting disease course remains challenging. We aimed to identify predictive factors associated with severe disease course in the first year after IBD diagnosis. Methods: Newly diagnosed adult (≥18 years) patients with IBD were recruited from a population-based inception cohort (IBSEN III study). Preselected baseline factors were tested for associations with severe disease course, defined as IBD-related hospitalisation, surgery, treatment with ≥2 steroid courses, >2 biologics and/or new event of complication (stricture, fistula, abscess only applicable Crohn's disease (CD)). From a best fitted multivariable logistic regression model stratified by diagnosis and age (18-40/>40 years), probability of severe disease for given combinations of predictive factors was summarised in prediction matrices. Results: At one-year follow-up, 90/559 (16%) patients with ulcerative colitis (UC) and 74/312 (24%) with CD had severe disease. Treatment with systemic steroids, vitamin D deficiency, Simple Clinical Colitis Activity Index >2, and hypoalbuminemia at diagnosis were all significantly associated with severe disease in UC patients. CD patients with stricturing or penetrating disease behaviour, systemic steroids and hypoalbuminemia at diagnosis were associated with severe disease course. The least favourable combination of these factors increased the probability of severe disease from 3% (95%CI[0-5%]) to 72% (95%CI[66-79%]) for UC and from 8% (95%CI[3-13%]) to 88% (95%CI[84-93%]) for CD. Conclusions: Our study identified predictive factors associated with severe disease the first year after diagnosis. The probability of severe disease summarised in matrices enables easy risk stratification.

• Hansen, Simen Hyll; Maseng, Maria Gjerstad; Grännö, Olle; Vestergaard, Marie V; Bang, Corinna & Olsen, Bjørn Christian Elias Grova [Vis alle 33 forfattere av denne artikkelen] (2025). Fecal Microbiome Reflects Disease State and Prognosis in Inflammatory Bowel Disease in an Adult Population-Based Inception Cohort. Inflammatory Bowel Diseases. ISSN 1078-0998. 31(8), s. 2066–2080. doi: 10.1093/ibd/izaf060. Fulltekst i vitenarkiv
• Strande, Vibeke; Lund, Charlotte; Hagen, Milada; Bengtson, May-Bente; Cetinkaya, Raziye Boyar & Detlie, Trond Espen [Vis alle 23 forfattere av denne artikkelen] (2024). Clinical course of ulcerative colitis: Frequent use of biologics and low colectomy rate first year after diagnosis—results from the IBSEN III inception cohort. Alimentary Pharmacology and Therapeutics. ISSN 0269-2813. 60(3), s. 357–368. doi: 10.1111/apt.18097. Fulltekst i vitenarkiv Vis sammendrag

  Background: The introduction of biologic therapies and the 'treat-to-target' treatment strategy may have changed the disease course of ulcerative colitis (UC). Aims: To describe the early disease course and disease outcome at 1-year follow-up in a population-based inception cohort of adult patients with newly diagnosed UC. Methods: The Inflammatory Bowel Disease in South-Eastern Norway (IBSEN) III study is a population-based inception cohort study with prospective follow-up. Patients newly diagnosed with inflammatory bowel disease during 2017-2019 were included. Patients ≥18 years at diagnosis of UC who attended the 1-year follow-up were investigated. We registered clinical, endoscopic and demographic data at diagnosis and 1-year follow-up. Results: We included 877 patients with UC (median age 36 years (range: 18-84), 45.8% female). At diagnosis, 39.2% presented with proctitis, 24.7% left-sided colitis and 36.0% extensive colitis. At the 1-year follow-up, 13.9% experienced disease progression, and 14.5% ha

• Dotsenko, Valeriia; Tewes, Bernhard; Hils, Martin; Pasternack, Ralf; Isola, Jorma & Taavela, Juha [Vis alle 34 forfattere av denne artikkelen] (2024). Transcriptomic analysis of intestine following administration of a transglutaminase 2 inhibitor to prevent gluten-induced intestinal damage in celiac disease. Nature Immunology. ISSN 1529-2908. 25, s. 1218–1230. doi: 10.1038/s41590-024-01867-0. Fulltekst i vitenarkiv Vis sammendrag

  Transglutaminase 2 (TG2) plays a pivotal role in the pathogenesis of celiac disease (CeD) by deamidating dietary gluten peptides, which facilitates antigenic presentation and a strong anti-gluten T cell response. Here, we elucidate the molecular mechanisms underlying the efficacy of the TG2 inhibitor ZED1227 by performing transcriptional analysis of duodenal biopsies from individuals with CeD on a long-term gluten-free diet before and after a 6-week gluten challenge combined with 100 mg per day ZED1227 or placebo. At the transcriptome level, orally administered ZED1227 effectively prevented gluten-induced intestinal damage and inflammation, providing molecular-level evidence that TG2 inhibition is an effective strategy for treating CeD. ZED1227 treatment preserved transcriptome signatures associated with mucosal morphology, inflammation, cell differentiation and nutrient absorption to the level of the gluten-free diet group. Nearly half of the gluten-induced gene expression changes in CeD were associated with the epithelial interferon-γ response. Moreover, data suggest that deamidated gluten-induced adaptive immunity is a sufficient step to set the stage for CeD pathogenesis. Our results, with the limited sample size, also suggest that individuals with CeD might benefit from an HLA-DQ2/HLA-DQ8 stratification based on gene doses to maximally eliminate the interferon-γ-induced mucosal damage triggered by gluten.

• Lund, Charlotte; Strande, Vibeke; Hagen, Milada; Bengtson, May-Bente; Cetinkaya, Raziye Boyar & Detlie, Trond Espen [Vis alle 26 forfattere av denne artikkelen] (2024). Low Surgery Rates in Early Crohn's Disease: Results from a Prospective Population-Based Inception Cohort—The Inflammatory Bowel Disease in South-Eastern Norway III Study. Inflammatory Bowel Diseases. ISSN 1078-0998. doi: 10.1093/ibd/izae297. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims: The emergence of biologic therapy has coincided with a decline in surgery rates for Crohn's disease (CD). This study aims to describe the disease course, including intra-abdominal surgery rates, biologic therapy use, and variables associated with biologic therapy initiation in a cohort of newly diagnosed CD patients. Methods: The Inflammatory Bowel Disease in South-Eastern Norway (IBSEN) III study is a population-based inception cohort study. From 2017 to 2019, newly diagnosed inflammatory bowel disease patients were included for prospective follow-up. The present study included CD patients ≥ 18 years. Clinical, endoscopic, and demographic data were collected at diagnosis and 1-year follow-up. Data were analyzed by using the Kaplan-Meier method and regression analyses. Results: In total, 424 CD patients (median age 37.0 years (range 18-80), female 55.0%) were included. At diagnosis, 50.5% presented with ileal disease and 80.7% with inflammatory behavior. Within a 1-year follow-up, 39.6%

• Vats, Anuja; Ahmad, Bilal; Floor, Pål Anders; Mohammed, Ahmed Kedir; Pedersen, Marius & Hovde, Øistein (2024). CAPTIV8: A Comprehensive Large Scale Capsule Endoscopy Dataset For Integrated Diagnosis. Proceedings of IEEE International Conference on Image Processing. ISSN 1522-4880. s. 76–82. doi: 10.1109/ICIP51287.2024.10647633. Fulltekst i vitenarkiv
• Zerouga, Insaf; Valeur, Jørgen; Sommer, Christine; Småstuen, Milada Cvancarova; Medhus, Asle Wilhelm & Lund, Charlotte [Vis alle 22 forfattere av denne artikkelen] (2024). Dietary intake and nutritional status in patients with newly diagnosed inflammatory bowel disease: insights from the IBSEN III study. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 59(6), s. 1–9. doi: 10.1080/00365521.2024.2313056. Fulltekst i vitenarkiv Vis sammendrag

  Background: Dietary recommendations in inflammatory bowel disease (IBD) are inconclusive, and patients may follow restrictive diets with increased risk of malnutrition. The aim of this study was to compare dietary intakes and nutritional status in men and women with newly diagnosed IBD with a general population sample, and to investigate whether intakes were in line with the Nordic Nutrition Recommendations. Methods: This was a cross-sectional study including adults≥ 40 years with IBD from the Inflammatory Bowel Disease in South-Eastern Norway (IBSEN) III cohort study. A validated food frequency questionnaire (FFQ) was used in dietary data collection, and a sample from the seventh survey of the Tromsø Study was included as a comparison group. Results: A total of 227 men and women with IBD were included. IBD patients had higher intake of grain products, sweetened beverages, energy, fat and polyunsaturated fat (PUFA), but lower intake of dairy products, alcohol and iodine compared to adults from the comparison sample (p < 0.01). Intakes of saturated fat and carbohydrates in both genders, and vitamin D in women were not within recommended levels. Anemia and hypoalbuminemia were more prevalent in IBD patients than in the comparison sample. Conclusions: Dietary intakes in newly diagnosed IBD patients were mostly in line with Nordic Nutrition Recommendations. Higher proportion of IBD patients exceeded recommended allowances of fat and added sugar than the comparison sample. Insufficient micronutrient intake, anemia and hypoalbuminemia are present challenges in IBD patients that require monitoring.

• Holten, Kristina Ingeborg; Bernklev, Tomm; Opheim, Randi; Johansen, Ingunn; Olsen, Bjørn Christian Elias Grova & Lund, Charlotte [Vis alle 22 forfattere av denne artikkelen] (2023). Fatigue in Patients with Newly Diagnosed Inflammatory Bowel Disease: Results from a Prospective Inception Cohort, the IBSEN III Study. Journal of Crohn's and Colitis. ISSN 1873-9946. 17(11), s. 1781–1790. doi: 10.1093/ecco-jcc/jjad094. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims: Although fatigue is common in inflammatory bowel disease (IBD), its pathogenesis remains unclear. This study aimed to determine the prevalence of fatigue and its associated factors in a cohort of patients newly diagnosed with IBD. Methods: Patients ≥18 years were recruited from the Inflammatory Bowel Disease South-Eastern Norway (IBSEN III) study, a population-based, observational inception cohort. Fatigue was assessed using the Fatigue Questionnaire and compared with data from a Norwegian general population. Univariate and multivariate linear and logistic regression analyses were performed to evaluate the associations of total fatigue (TF) (continuous score) and substantial fatigue (SF) (dichotomized score ≥4) with sociodemographic, clinical, endoscopic, laboratory, and other relevant patient data. Results: In total, 983/1509 (65.1%) patients with complete fatigue data were included (ulcerative colitis (UC), 68.2%; Crohn's disease (CD), 31.8%). The prevalence of SF was higher in CD (69.6%) compared with UC (60.2%) (p<0.01), and in both diagnoses when compared to the general population (p<0.001).In the multivariate analyses, depressive symptoms, pain intensity, and sleep disturbances were associated with increased TF for both diagnoses. In addition, increased clinical disease activity and Mayo endoscopic score were significantly associated with TF in UC, whereas all disease-related variables were insignificant in CD. Similar findings were observed for SF, except regarding the Mayo endoscopic score. Conclusions: SF affects approximately two-thirds of patients newly diagnosed with IBD. Fatigue was associated with depressive symptoms, sleep disturbances, and increased pain intensity in both diagnoses, while clinical and endoscopic activity were associated factors only in UC.

• Follin-Arbelet, Benoit; Småstuen, Milada Cvancarova; Hovde, Øistein; Jelsness-Jørgensen, Lars-Petter & Moum, Bjørn Allan (2023). Incidence of cancer in patients with ulcerative colitis 30 years after diagnosis (the IBSEN study). Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 58(11). doi: 10.1080/00365521.2023.2223709. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: Patients with ulcerative colitis (UC) have shown an increased risk for colorectal cancer, hepatobiliary, hematologic, and skin cancers, but updated long-term data is needed. This study aimed to estimate the risk of cancer in patients with UC compared to the general Norwegian population, in a population-based cohort (the IBSEN study), 30 years after diagnosis; and to identify possible risk factors associated with cancer. Methods: The IBSEN cohort prospectively included all incident patients between 1990 and 1993. Cancer incidence data were obtained from the Cancer Registry of Norway. The overall and cancer-specific hazard ratios (HR) were modelled using Cox regression. Standardized incidence ratios were estimated compared to the general population. Results: In total, the cohort included 519 patients, and 83 cases were diagnosed with cancer. There was no statistically significant difference in the overall cancer risk (HR = 1.01, 95% CI: [0.79-1.29]) and colorectal cancer risk (HR = 1.37, 95% CI: [0.75-2.47]) between patients and controls. The incidence of biliary tract cancer was higher than expected (SIR = 9.84, 95%CI: [3.19-20.15]), especially when UC patients suffered from primary sclerosing cholangitis. Male UC patients were also more at risk of being diagnosed with hematologic malignancies (HR = 3.48, 95% CI: [1.55-7.82]). Being prescribed thiopurines was associated with a higher risk of cancer (HR = 2.03, 95% CI: [1.02-4.01]). Conclusions: At 30 years after diagnosis, the risk of all cancer in patients with UC was not significantly increased compared with the general population. However, the risks of biliary tract cancer and hematologic cancers were increased, particularly in male patients.

• Vats, Anuja; Pedersen, Marius; Mohammed, Ahmed Kedir & Hovde, Øistein (2023). Evaluating clinical diversity and plausibility of synthetic capsule endoscopic images. Scientific Reports. 13(1). doi: 10.1038/s41598-023-36883-x. Fulltekst i vitenarkiv Vis sammendrag

  Wireless Capsule Endoscopy (WCE) is being increasingly used as an alternative imaging modality for complete and non-invasive screening of the gastrointestinal tract. Although this is advantageous in reducing unnecessary hospital admissions, it also demands that a WCE diagnostic protocol be in place so larger populations can be efectively screened. This calls for training and education protocols attuned specifcally to this modality. Like training in other modalities such as traditional endoscopy, CT, MRI, etc., a WCE training protocol would require an atlas comprising of a large corpora of images that show vivid descriptions of pathologies, ideally observed over a period of time. Since such comprehensive atlases are presently lacking in WCE, in this work, we propose a deep learning method for utilizing already available studies across diferent institutions for the creation of a realistic WCE atlas using StyleGAN. We identify clinically relevant attributes in WCE such that synthetic images can be generated with selected attributes on cue. Beyond this, we also simulate several disease progression scenarios. The generated images are evaluated for realism and plausibility through three subjective online experiments with the participation of eight gastroenterology experts from three geographical locations and a variety of years of experience. The results from the experiments indicate that the images are highly realistic and the disease scenarios plausible. The images comprising the atlas are available publicly for use in training applications as well as supplementing real datasets for deep learning.

• Follin-Arbelet, Benoit; Småstuen, Milada Cvancarova; Hovde, Øistein; Jelsness-Jørgensen, Lars-Petter & Moum, Bjørn Allan (2023). Risk of Cancer in Patients With Crohn's Disease 30 Years After Diagnosis (the IBSEN Study). Crohn's & Colitis 360. 5(4), s. 1–6. doi: 10.1093/crocol/otad057. Fulltekst i vitenarkiv Vis sammendrag

  Background: Patients with Crohn's disease (CD) are most often diagnosed as young adults; therefore, long-term studies are needed to assess the risk of cancer over their lifetime. Thus, the aims of the present study were to determine the risk of cancer in a Norwegian population-based cohort (the Inflammatory Bowel South Eastern Norway [IBSEN] study), 30 years after diagnosis, and to assess whether patients with CD were at an increased risk of specific cancer types. Methods: The IBSEN cohort prospectively included all incident patients diagnosed between 1990 and 1993. Data on cancer incidence were obtained from the Cancer Registry of Norway. Overall and cancer-specific hazard ratios (HRs) for CD patients compared with age- and sex-matched controls were modeled using Cox regression. Standardized incidence ratios (SIRs) were estimated compared to the general population. Results: In total, the cohort included 237 patients with CD, and 36 of them were diagnosed with cancer. Compared to the general Norwegian population, patients with CD had an increased overall risk of cancer (HR = 1.56, 95% CI: 1.06-2.28), particularly male patients (HR = 1.85, 95% CI: 1.08-3.16). The incidence of lung cancer and nonmelanoma skin cancer was increased; however, the difference was not statistically significant (SIR = 2.29, 95% CI: 0.92-4.27 and SIR = 2.45, 95% CI: 0.67-5.37, respectively). Conclusions: After 30 years of follow-up, the risk of all cancers in patients with CD was increased compared to the general population. Keywords: Cancer; Crohn’s disease. © The Author(s) 2023. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation.

• Vatine, Leo; Floor, Pål Anders; Pedersen, Marius; Nussbaum, Peter Stefan; Ahmad, Bilal & Hovde, Øistein (2023). Enhancement of Colour Reproduction for Capsule Endoscopy Images. I Cheikh, Faouzi Alaya; Beghdadi, Azeddine Boutkhil & Colonnese, Stefania (Red.), 2023 11th European Workshop on Visual Information Processing (EUVIP). IEEE (Institute of Electrical and Electronics Engineers). ISSN 9798350342185. s. 1–6. doi: 10.1109/EUVIP58404.2023.10323058. Fulltekst i vitenarkiv
• Ahmad, Bilal; Floor, Pål Anders; Farup, Ivar & Hovde, Øistein (2023). 3D Reconstruction of Gastrointestinal Regions Using Single-View Methods. IEEE Access. 11, s. 61103–61117. doi: 10.1109/ACCESS.2023.3286937. Fulltekst i vitenarkiv Vis sammendrag

  Capsule endoscopy is about to become an alternative to traditional colonoscopy. One uses a wireless camera to visualize the gastrointestinal (GI) tract. A 3D model based on image sequences obtained from wireless capsule endoscopy (WCE) can be helpful to diagnose or analyse areas of interests. We have therefore investigated the possibility to provide enhanced viewing for gastroenterologists by reconstructing 3D shapes from WCE images. The study is done on virtual graphics-based models of human GI regions. The shape from shading (SFS) method is applied to colon images and the quality of the reconstructed shapes is compared with ground truth models. WCE images suffer from uneven and dim illumination due to point light source. Therefore, we provide a method based on surface normals from reconstructed 3D models to enhance contrast particularity in images capturing larger depths by changing the illumination from point light to directional light. Images of different resolution are also tested to evaluate their effect on the quality of the 3D reconstruction. We have also tested the shape from focus (SFF) method, a possibility for future WCEs, and compared the results with SFS. Finally, enhanced images and 3D shapes recovered with both methods have been evaluated by gastroenterologists through subjective experiments. Objective experiments indicate that both methods are capable of reconstructing the 3D shapes of colon images successfully, but the SFF method is better at retaining details in the reconstructed models than the SFS method. Subjective experiments show that contrast enhanced images are highly preferred over original images. Also, having the reconstructed 3D models in addition to the images during evaluation is found to be very useful by gastroenterologists and sometimes even being preferred over the original image.

• Tejera, Valeria Castro; Öhman, Lena; Aabakken, Lars; Fellström, Bengt; Hausken, Trygve & Hovde, Øistein [Vis alle 11 forfattere av denne artikkelen] (2022). Randomised clinical trial and meta-analysis: mesalazine treatment in irritable bowel syndrome—effects on gastrointestinal symptoms and rectal biomarkers of immune activity. Alimentary Pharmacology and Therapeutics. ISSN 0269-2813. 56(6), s. 968–979. doi: 10.1111/apt.17182. Fulltekst i vitenarkiv Vis sammendrag

  Background: Low-grade immune activation in the gut is a potential treatment target in irritable bowel syndrome (IBS). Aims: To determine improvement in IBS symptoms after mesalazine treatment, and the utility of measures of immune activity in the rectal mucosa METHODS: This was a randomised, double-blind, placebo-controlled, parallel-arm, multicentre trial in subjects with IBS (Rome III criteria), with an eight-week treatment period of mesalazine 2400 mg or plcebo once-daily. The primary endpoint was the global assessment of satisfactory relief of IBS symptoms in ≥50% of weeks during intervention. IBS symptoms were also measured with the IBS severity scoring system; immune activity was measured by mucosal patch technology. A post hoc meta-analysis of randomised placebo-controlled trials of mesalazine in IBS was added. Results: Of 181 included patients, 91 received mesalazine and 90 received placebo. The primary endpoint was met by 32 (36%) patients after mesalazine and 27 (30%) after placebo (p = 0.40). There were no differences in response rates related to IBS subtype or post-infection symptom onset. More reduction of abdominal bloating was noted in the mesalazine group (p = 0.02). The meta-analysis showed no effect of mesalazine on IBS symptoms. No mucosal patch technology measure could predict response to mesalazine, and found no differences in the effects of intervention on levels of immune markers. Conclusions: Mesalazine is ineffective in reducing IBS symptoms. Rectal measures of immune activity by the mucosal patch technology cannot predict a higher chance of response to mesalazine. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2022 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.

• Follin-Arbelet, Benoit; Småstuen, Milada Cvancarova; Hovde, Øistein; Jelsness-Jørgensen, Lars-Petter & Moum, Bjørn Allan (2022). Mortality in Patients with Inflammatory Bowel Disease: Results from 30 Years of Follow-up in a Norwegian Inception Cohort (the IBSEN study). Journal of Crohn's and Colitis. ISSN 1873-9946. 17(4), s. 497–503. doi: 10.1093/ecco-jcc/jjac156. Fulltekst i vitenarkiv Vis sammendrag

  Background and Aims: Patients with longstanding inflammatory bowel disease [IBD] may be at an increased risk of death compared to the general population, especially elderly patients. The Inflammatory Bowel South-Eastern Norway [IBSEN] study has previously detected a small but not statistically significant increase in mortality 20 years after diagnosis. The aim of this study was to evaluate the overall and cause-specific mortality at 30 years of follow-up. Methods: The IBSEN cohort included 519 incident patients with ulcerative colitis [UC] and 237 patients with Crohn’s disease [CD] between 1990 and 1993, each matched with five controls. Death certificate data were obtained from the Norwegian Cause of Death Registry. The underlying causes of death were categorized into five groups: all cancers, gastrointestinal cancers, cardiovascular diseases, infections and all other causes. Hazard ratios [HRs] were modelled using Cox regression. Results: There was no statistically significant difference in the overall mortality rates. However, in patients with CD, male sex (HR = 1.65 [95% CI: 1.04–2.62]), onset after 40 years of age (HR = 1.72 [1.19–2.48]), colonic disease (HR = 1.57 [1.05–2.35]) and penetrating behaviour (HR = 3.3 [1.41–7.76]) were clinical factors associated with an increased mortality. IBD patients were at a higher risk of death due to cardiovascular disease: HR = 1.51 [1.10–2.08] for UC and 2.04 [1.11–3.77] for CD. When taking into account both the underlying and the immediate cause of death, infection was more frequent in patients with IBD. Conclusions: Overall, all-cause mortality rates were similar between patients with IBD and controls. However, clinicians should remain alert to cardiovascular diseases and infections, particularly in specific subgroups of CD patients. Key Words: Inflammatory bowel disease; mortality; population-based study © The Author(s) 2022. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

• Jelsness-Jørgensen, Lars-Petter; Moum, Bjørn Allan; Grimstad, Tore Bjørn; Jahnsen, Jørgen; Hovde, Øistein & Frigstad, Svein Oskar [Vis alle 7 forfattere av denne artikkelen] (2022). The multidimensional fatigue inventory (MFI-20): psychometrical testing in a Norwegian sample of inflammatory bowel disease (IBD) patients. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. s. 1–7. doi: 10.1080/00365521.2022.2029939. Fulltekst i vitenarkiv Vis sammendrag

  OBJECTIVES To evaluate the psychometric properties of the Norwegian version of the multidimensional fatigue inventory (MFI-20) in patients with inflammatory bowel disease. METHODS Participants were recruited from nine hospitals in the southeastern and western parts of Norway. Clinical and sociodemographic data were collected, and participants completed the MFI-20, as well as the Fatigue Questionnaire (FQ). In addition to a confirmatory factor analysis, validity, reliability, test-retest and responsiveness were evaluated. RESULTS In total, 410 patients were included. The Norwegian MFI-20 had an acceptable model fit when compared to the original five-dimensional structure. A positive correlation was observed between the dimensions of MFI-20 and the FQ. MFI-20 scores increased according to subjective disease activity, but no differences were observed when using a calprotectin cut-off < or > =250 µg/g mg/kg. All MFI-20 dimensions except ‘reduced motivation’ in both ulcerative colitis (UC) and Crohn’s disease (CD) patients had alpha Cronbach alpha values ≥70, and test-retest reliability revealed good to excellent values. Merely one dimension (Reduced activity) in UC patients reporting improvement did not reach the threshold for acceptable responsiveness according to Guyatt statistics. CONCLUSIONS The Norwegian version of MFI-20 is valid, reliable and responsive. The instrument can safely be used in studies using fatigue as an endpoint.

• Schuppan, Detlef; Maki, Markku; Lundin, Knut Erik Aslaksen; Isola, Jorma; Friesing-Sosnik, Tina & Taavela, Juha [Vis alle 26 forfattere av denne artikkelen] (2021). A Randomized Trial of a Transglutaminase 2 Inhibitor for Celiac Disease. New England Journal of Medicine. ISSN 0028-4793. 385(1), s. 35–45. doi: 10.1056/NEJMoa2032441. Fulltekst i vitenarkiv Vis sammendrag

  Background: In celiac disease, small intestinal transglutaminase 2 causes deamidation of glutamine residues in gluten peptides, which enhances stimulation of T cells and leads to mucosal injury. Inhibition of transglutaminase 2 is a potential treatment for celiac disease. Methods: In a proof-of-concept trial, we assessed the efficacy and safety of a 6-week treatment with ZED1227, a selective oral transglutaminase 2 inhibitor, at three dose levels as compared with placebo, in adults with well-controlled celiac disease who underwent a daily gluten challenge. The primary end point was the attenuation of gluten-induced mucosal damage, as measured by the ratio of villus height to crypt depth. Secondary end points included intraepithelial lymphocyte density, the Celiac Symptom Index score, and the Celiac Disease Questionnaire score (for assessment of health-related quality of life). Results: Of the 41 patients assigned to the 10-mg ZED1227 group, the 41 assigned to the 50-mg group, the 41 assigned to the 100-mg group, and the 40 assigned to the placebo group, 35, 39, 38, and 30 patients, respectively, had adequate duodenal-biopsy samples for the assessment of the primary end point. Treatment with ZED1227 at all three dose levels attenuated gluten-induced duodenal mucosal injury. The estimated difference from placebo in the change in the mean ratio of villus height to crypt depth from baseline to week 6 was 0.44 (95% confidence interval [CI], 0.15 to 0.73) in the 10-mg group (P = 0.001), 0.49 (95% CI, 0.20 to 0.77) in the 50-mg group (P<0.001), and 0.48 (95% CI, 0.20 to 0.77) in the 100-mg group (P<0.001). The estimated differences from placebo in the change in intraepithelial lymphocyte density were -2.7 cells per 100 epithelial cells (95% CI, -7.6 to 2.2) in the 10-mg group, -4.2 cells per 100 epithelial cells (95% CI, -8.9 to 0.6) in the 50-mg group, and -9.6 cells per 100 epithelial cells (95% CI, -14.4 to -4.8) in the 100-mg group. Use of the 100-mg dose may have improved symptom and quality-of-life scores. The most common adverse events, the incidences of which were similar across all groups, were headache, nausea, diarrhea, vomiting, and abdominal pain. Rash developed in 3 of 40 patients (8%) in the 100-mg group. Conclusions: In this preliminary trial, treatment with ZED1227 attenuated gluten-induced duodenal mucosal damage in patients with celiac disease. (Funded by Dr. Falk Pharma; CEC-3 EudraCT number, 2017-002241-30.). Copyright © 2021 Massachusetts Medical Society.

• Vats, Anuja; Pedersen, Marius; Mohammed, Ahmed Kedir & Hovde, Øistein (2021). Learning More for Free-A Multi Task Learning Approach for Improved Pathology Classification in Capsule Endoscopy, Medical Image Computing and Computer Assisted Intervention – MICCAI 2021 24th International Conference, Strasbourg, France, September 27 – October 1, 2021, Proceedings, Part VII. Springer. ISSN 9783030872342. s. 3–13. doi: 10.1007/978-3-030-87234-2_1. Fulltekst i vitenarkiv Vis sammendrag

  The progress in Computer Aided Diagnosis (CADx) of Wireless Capsule Endoscopy (WCE) is thwarted by the lack of data. The inadequacy in richly representative healthy and abnormal conditions results in isolated analyses of pathologies, that can not handle realistic multi-pathology scenarios. In this work, we explore how to learn more for free, from limited data through solving a WCE multicentric, multi-pathology classification problem. Learning more implies to learning more than full supervision would allow with the same data. This is done by combining self supervision with full supervision, under multi task learning. Additionally, we draw inspiration from the Human Visual System (HVS) in designing self supervision tasks and investigate if seemingly ineffectual signals within the data itself can be exploited to gain performance, if so, which signals would be better than others. Further, we present our analysis of the high level features as a stepping stone towards more robust multi-pathology CADx in WCE. Code accompanying this work will be made available on github.

• Monstad, Iril Lovise; Solberg, Inger Camilla; Småstuen, Milada Cvancarova; Hovde, Oistein; Henriksen, Magne & Huppertz-Hauss, Gert [Vis alle 12 forfattere av denne artikkelen] (2021). Outcome of Ulcerative Colitis 20 Years after Diagnosis in a Prospective Population-based Inception Cohort from South-Eastern Norway, the IBSEN Study. Journal of Crohn's and Colitis. ISSN 1873-9946. 15(6), s. 969–979. doi: 10.1093/ecco-jcc/jjaa232. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims: The long-term course of ulcerative colitis [UC] is difficult to predict. Mortality, colectomy, cancer, and hospitalisation represent hard outcomes of disease. Moreover, knowledge on the risk of relapses and need for potent medication add important information about living with UC. We aimed to evaluate the course and prognosis of UC during the first 20 years after diagnosis, and to identify early prognostic risk factors. Methods: From 1990 to 1994, a population-based inception cohort of patients with inflammatory bowel disease was enrolled in South-Eastern Norway. A systematic follow-up [FU] was conducted at 1,5, 10, and 20 years after diagnosis. Clinical outcomes were recorded continuously, and possible relationships between early disease characteristics and outcomes were analysed using multiple regression analysis. Results: Among 519 UC patients, 119 died, 60 were lost to FU, and 340 were included in the FU cohort. The 20-year cumulative risk of colectomy was 13.0% (95% confidence interval [CI] [11.4-14.6]). Extensive colitis at diagnosis was independently associated with an increased risk of colectomy compared with proctitis (hazard ratio [HR] = 2].8, 95% CI [1.3-6.1]). In contrast, mucosal healing at 1-year FU was independently associated with reduced risk of colectomy [HR = 0.4, 95% CI [0.2-0.8]), and inversely associated with subsequent risk of relapse [adjusted HR = 0.5, 95% CI [0.3-0.7]). Conclusions: The overall risk of colectomy in our cohort was lower than expected from previous studies, although considerable for patients with extensive colitis at diagnosis. Early mucosal healing was associated with better disease outcomes 20 years after diagnosis.

• Kristensen, Vendel Ailin; Opheim, Randi; Perminow, Gøri Margrete; Huppertz-Hauss, Gert; Detlie, Trond Espen & Lund, Charlotte [Vis alle 39 forfattere av denne artikkelen] (2021). Inflammatory bowel disease in South-Eastern Norway III (IBSEN III): a new population-based inception cohort study from South-Eastern Norway. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 56(8), s. 899–905. doi: 10.1080/00365521.2021.1922746. Fulltekst i vitenarkiv Vis sammendrag

  Background and aim: Modern treatment strategies for inflammatory bowel disease (IBD) are postulated to change the natural disease course. Inception cohort studies are the gold standard for investigating such changes. We have initiated a new population-based inception cohort study; Inflammatory bowel disease in South Eastern Norway III (IBSEN III). In this article, we describe the study protocol and baseline characteristics of the cohort. Methods: IBSEN III is an ongoing, population-based observational inception cohort study with prospective follow-up. Adult and pediatric patients with suspected IBD in the South-Eastern Health Region of Norway (catchment area of 2.95 million inhabitants in 2017), during the 3-year period from 2017 to 2019, were eligible for inclusion. Comprehensive clinical, biochemical, endoscopic, demographic, and patient-reported data were collected at the time of diagnosis and throughout standardized follow-up. For a portion of the patients, extensive biological material was biobanked. Results: The study included 2168 patients, of whom 1779 were diagnosed with IBD (Crohn's disease: 626, ulcerative colitis: 1082, IBD unclassified: 71). In 124 patients, there were subtle findings indicative of, but not diagnostic for, IBD. The remaining 265 patients were classified as symptomatic non-IBD controls. Conclusion: We have included patients in a comprehensive population-based IBD cohort from a catchment population of 2.95 million, and a unique biobank with materials from newly diagnosed and treatment-naïve IBD patients and symptomatic non-IBD controls. We believe this cohort will add important knowledge about IBD in the years to come.

• Opheim, Randi; Moum, Bjørn; Grimstad, Tore; Jahnsen, Jørgen; Berset, Ingrid Prytz & Hovde, Øistein [Vis alle 9 forfattere av denne artikkelen] (2020). Self-esteem in patients with inflammatory bowel disease. Quality of Life Research. ISSN 0962-9343. 29(7), s. 1839–1846. doi: 10.1007/s11136-020-02467-9. Fulltekst i vitenarkiv Vis sammendrag

  Purpose The purpose of this study was to explore self-esteem and associations between self-esteem and sociodemographic, clinical, and psychological factors in patients with infammatory bowel disease (IBD), a disease of chronic relapsing infammation of the gastrointestinal tract. IBD symptoms, including pain, fatigue, and diarrhea, as well as potential life-long medical treatment and surgery, may be demanding, cause signifcant challenges, and infuence self-esteem. Methods In this cross-sectional multicenter study, participants were recruited from nine hospitals in the southeastern and western regions of Norway from March 2013 to April 2014. Data were collected using self-report questionnaires. Selfesteem was assessed by the Rosenberg Self-Esteem Scale, fatigue was assessed by the Fatigue Questionnaire, self-efcacy was assessed by the General Self-Efcacy Scale, and disease activity was assessed by the Simple Clinical Colitis Activity Index for ulcerative colitis (UC) and Harvey Bradshaw Index for Crohn’s disease (CD). Multiple linear regression analysis was applied to examine associations between self-esteem and sociodemographic, clinical, and psychological factors. Results In total, 411 of 452 (91%) patients had evaluable data and were included in this study. The mean scores on selfesteem, self-efcacy, total fatigue, anxiety, and depression were similar between UC patients and CD patients. Male gender, being employed, and higher self-efcacy were independently associated with higher self-esteem, whereas anxiety and depression were independently associated with lower self-esteem. Neither disease activity nor fatigue were associated with self-esteem in the fnal multiple regression analyses. Conclusion Patient-centered interventions that improve self-esteem and reduce anxiety and depression seem to be important to optimize IBD management. Keywords Self-esteem · Self-efcacy · Coping · Infammatory bowel disease · Ulcerative colitis · Crohn’s disease · Health psychology · Chronic disease · Health-related quality of life

• Klepp, Pasquale Catherine; Brackmann, Stephan; Småstuen, Milada Cvancarova; Høivik, Marte Lie; Hovde, Øistein & Henriksen, Magne [Vis alle 15 forfattere av denne artikkelen] (2020). Risk of colorectal cancer in a population-based study 20 years after diagnosis of ulcerative colitis: results from the IBSEN study. BMJ open gastroenterology. 7. doi: 10.1136/bmjgast-2019-000361. Fulltekst i vitenarkiv Vis sammendrag

  Objective The association between ulcerative colitis (UC) and colorectal cancer (CRC) is widely accepted, although attenuated risk has been reported in recent years. Colonoscopic surveillance is recommended with intervals based on established clinical risk factors. Nevertheless, a significant number of patients develop interval cancers, indicating the need of improved individualised assessment. In the present study, we evaluated clinical risk factors associated with CRC during a prescheduled follow-up 20 years after diagnosis, the IBSEN study. Design A population-based inception cohort of patients diagnosed with inflammatory bowel disease from 1 January 1990 until 31 December 1993, prospectively followed at 1, 5, 10 and 20 years after diagnosis. A total of 517 patients with UC were included; 264 (51 %) men; median age at inclusion 37.4 years (4–88). Results The overall incidence of CRC was 1.6% (8/517) at a 20-year follow-up. The total lifetime risk of CRC prior to or after UC diagnosis was 2.3%. (12/517). Patients older than 70 years at diagnosis had a 15-fold higher risk of CRC compared with those diagnosed when younger than 40 years, with HR 15.68 (95% CI: 1.31 to 187.92). Neither sex, first-degree relative with CRC, extent of colitis nor primary sclerosing cholangitis affected the risk of CRC. Conclusion The risk of CRC in UC was low and comparable with the risk of CRC in the background population of Norway.

• Frigstad, Svein Oskar; Høivik, Marte Lie; Jahnsen, Jørgen; Småstuen, Milada C; Grimstad, Tore & Berset, Ingrid Prytz [Vis alle 11 forfattere av denne artikkelen] (2020). Pain Severity and Vitamin D Deficiency in IBD Patients. Nutrients. 12(1), s. 1–12. doi: 10.3390/nu12010026. Fulltekst i vitenarkiv Vis sammendrag

  Background: Pain and vitamin D deficiency are common in inflammatory bowel disease (IBD). Disease activity, fatigue, frequent relapses, prior surgery and psychological factors all seem to influence the experience of pain in IBD. Vitamin D deficiency has been associated with muscle and skeletal pain. This study aimed to determine whether there is an association between vitamin D deficiency and severity of pain in patients with IBD, and to investigate the influence of other socio-demographic and psychological variables on the experience of pain. Methods: Patients with IBD were recruited from nine hospitals in Norway in a multicenter cross-sectional study. The Brief Pain Inventory (BPI) questionnaire was used to measure pain. Disease activity was assessed using clinical disease activity indices, C-reactive protein (CRP) and fecal calprotectin. Regression models were fitted to explore a possible association between 25-hydroxyvitamin D and pain severity. Results: Of 407 patients included in the analyses, 229 (56%) had Crohn's disease (CD) and 178 (44%) had ulcerative colitis (UC). Vitamin D deficiency was present in half (203/407) of patients. Presence of pain was reported by 76% (309/407). More severe pain was associated with female gender and increased disease activity scores, but not with increased CRP or fecal calprotectin. In CD, patients without prior intra-abdominal surgery reported more severe pain. In multivariate analyses, there was no association between 25-hydroxyvitamin D and pain severity. Conclusions: In this study, no significant association between pain severity and vitamin D deficiency was revealed in patients with IBD. Keywords: pain severity; patient reported outcomes; vitamin D deficiency.

• Floor, Pål Anders; Farup, Ivar; Pedersen, Marius & Hovde, Øistein (2020). Error reduction through post processing for wireless capsule endoscope video. EURASIP Journal on Image and Video Processing. ISSN 1687-5176. doi: 10.1186/s13640-020-00503-9. Fulltekst i vitenarkiv Vis sammendrag

  The wireless capsule endoscope (WCE) is a pill-sized device taking images, which are transmitting to an on-body receiver, while traveling through the digestive system. Since image data is transmitted through the human body, which is a harsh medium for electromagnetic wave propagation, noise may at times heavily corrupt the reconstructed image frames. A common way to combat noise is to use error-correcting codes. In addition one may also utilize interand intra frame correlation to reduce the impact of noise at the receiver side, placing no extra demand on the WCE. However, it is then of great importance that the chosen post processing methods do not alter the content of the image as this can lead to miss-detection by gastroenterologists. In this paper we will investigate the possibility for additional noise suppression and error concealment at the receiver side in a high intensity error regime. Due to the high correlation generally inherent in WCE video, satisfactory results are obtained, as concluded from both subjective tests with gastroenterologists as well as the structural similarity (SSIM) metric. More surprisingly, the subjective tests indicate that the inpainted frames in many cases can be used for clinical assessment. These results indicate that one can apply error reduction through post processing together with error-correcting codes to obtain a more noise-robust system without any further demand on the WCE. Keywords: Wireless capsule endoscope, Error reduction and concealment, Image post processing, Subjective testing, Ultra wide band, SSIM

• Mohammed, Ahmed Kedir; Farup, Ivar; Pedersen, Marius; Yayilgan, Sule Yildirim & Hovde, Øistein (2020). PS-DeVCEM: Pathology-sensitive deep learning model for video capsule endoscopy based on weakly labeled data. Computer Vision and Image Understanding. ISSN 1077-3142. 201:103062, s. 1–11. doi: 10.1016/j.cviu.2020.103062. Fulltekst i vitenarkiv Vis sammendrag

  Abstract We propose a novel pathology-sensitive deep learning model (PS-DeVCEM) for frame-level anomaly detection and multi-label classification of different colon diseases in video capsule endoscopy (VCE) data. Our proposed model is capable of coping with the key challenge of colon apparent heterogeneity caused by several types of diseases. Our model is driven by attention-based deep multiple instance learning and is trained end-to-end on weakly labeled data using video labels instead of detailed frame-by-frame annotation. This makes it a cost-effective approach for the analysis of large capsule video endoscopy repositories. Other advantages of our proposed model include its capability to localize gastrointestinal anomalies in the temporal domain within the video frames, and its generality, in the sense that abnormal frame detection is based on automatically derived image features. The spatial and temporal features are obtained through ResNet50 and residual Long short-term memory (residual LSTM) blocks, respectively. Additionally, the learned temporal attention module provides the importance of each frame to the final label prediction. Moreover, we developed a self-supervision method to maximize the distance between classes of pathologies. We demonstrate through qualitative and quantitative experiments that our proposed weakly supervised learning model gives a superior precision and F1-score reaching, 61.6% and 55.1%, as compared to three state-of-the-art video analysis methods respectively. We also show our model’s ability to temporally localize frames with pathologies, without frame annotation information during training. Furthermore, we collected and annotated the first and largest VCE dataset with only video labels. The dataset contains 455 short video segments with 28,304 frames and 14 classes of colorectal diseases and artifacts. Dataset and code supporting this publication will be made available on our home page.

• Mulliqi, Nita; Yayilgan, Sule Yildirim; Mohammed, Ahmed Kedir; Ahmedi, Lule; Wang, Hao & Elezaj, Ogerta [Vis alle 7 forfattere av denne artikkelen] (2020). The Importance Of Skip Connections In Encoder-Decoder Architectures For Colorectal Polyp Detection, Proceedings of IEEE international conference on image processing. IEEE Signal Processing Society. ISSN 9781728163956. s. 380–384. doi: 10.1109/ICIP40778.2020.9191310. Fulltekst i vitenarkiv Vis sammendrag

  Accurate polyp detection during the colonoscopy procedure impacts colorectal cancer prevention and early detection. In this paper, we investigate the influence of skip connections as the main component of encoder-decoder based convolutional neural network (CNN) architectures for colorectal polyp detection. We conduct experiments on long and short skip connections and further extend the existing architecture by introducing dense lateral skip connections. The proposed segmentation architecture utilizes short skip connections in the contracting path, moreover it utilizes dense long and lateral skip connections in between the contracting and expanding path. Results obtained from the MICCAI 2015 Challenge dataset show progressive improvement of the segmentation result with expanded utilization of skip connections. The proposed colorectal polyp segmentation architecture achieves performance comparable to the state-of-the-art under significantly reduced number of model parameters.

• Mohammed, Ahmed Kedir; Yayilgan, Sule Yildirim; Farup, Ivar; Pedersen, Marius & Hovde, Øistein (2019). StreoScenNet: Surgical stereo robotic scene segmentation. Progress in Biomedical Optics and Imaging. ISSN 1605-7422. 1095:109510P1. doi: 10.1117/12.2512518. Fulltekst i vitenarkiv Vis sammendrag

  Surgical robot technology has revolutionized surgery toward a safer laparoscopic surgery and ideally been suited for surgeries requiring minimal invasiveness. Sematic segmentation from robot-assisted surgery videos is an essential task in many computer-assisted robotic surgical systems. Some of the applications include instrument detection, tracking and pose estimation. Usually, the left and right frames from the stereoscopic surgical instrument are used for semantic segmentation independently from each other. However, this approach is prone to poor segmentation since the stereo frames are not integrated for accurate estimation of the surgical scene. To cope with this problem, we proposed a multi encoder and single decoder convolutional neural network named StreoScenNet which exploits the left and right frames of the stereoscopic surgical system. The proposed architecture consists of multiple ResNet encoder blocks and a stacked convolutional decoder network connected with a novel sum-skip connection. The input to the network is a set of left and right frames and the output is a mask of the segmented regions for the left frame. It is trained end-to-end and the segmentation is achieved without the need of any pre- or post-processing. We compare the proposed architectures against state-of-the-art fully convolutional networks. We validate our methods using existing benchmark datasets that includes robotic instruments as well as anatomical objects and non-robotic surgical instruments. Compared with the previous instrument segmentation methods, our approach achieves a significant improved Dice similarity coefficient.

• Mohammed, Ahmed Kedir; Farup, Ivar; Pedersen, Marius; Hovde, Øistein & Yayilgan, Sule Yildirim (2018). Stochastic Capsule Endoscopy Image Enhancement. Journal of Imaging. 4(6). doi: 10.3390/jimaging4060075. Fulltekst i vitenarkiv Vis sammendrag

  Capsule endoscopy, which uses a wireless camera to take images of the digestive tract, is emerging as an alternative to traditional colonoscopy. The diagnostic values of these images depend on the quality of revealed underlying tissue surfaces. In this paper, we consider the problem of enhancing the visibility of detail and shadowed tissue surfaces for capsule endoscopy images. Using concentric circles at each pixel for random walks combined with stochastic sampling, the proposed method enhances the details of vessel and tissue surfaces. The framework decomposes the image into two detailed layers that contain shadowed tissue surfaces and detail features. The target pixel value is recalculated for the smooth layer using similarity of the target pixel to neighboring pixels by weighting against the total gradient variation and intensity differences. In order to evaluate the diagnostic image quality of the proposed method, we used clinical subjective evaluation with a rank order on selected KID image database and compared it to state-of-the-art enhancement methods. The result showed that the proposed method provides a better result in terms of diagnostic image quality and objective quality contrast metrics and structural similarity index.

• Frigstad, Svein Oskar; Høivik, Marte Lie; Jahnsen, Jørgen; Småstuen, Milada Cvancarova; Grimstad, Tore & Berset, Ingrid Prytz [Vis alle 11 forfattere av denne artikkelen] (2018). Fatigue is not associated with vitamin D deficiency in inflammatory bowel disease patients. World Journal of Gastroenterology (WJG). ISSN 1007-9327. 24(29), s. 3293–3301. doi: 10.3748/wjg.v24.i29.3293. Fulltekst i vitenarkiv Vis sammendrag

  AIM To investigate if vitamin D deficiency is associated with fatigue in patients with inflammatory bowel disease (IBD). METHODS IBD patients were recruited from nine hospitals in the southeastern and western regions of Norway to participate in a multicenter cross-sectional study lasting from March 2013 to April 2014. Data were collected by interviews, from medical records and laboratory tests. The Fatigue Questionnaire (FQ) was used to measure fatigue. Linear and logistic regression models were applied to explore the possible association between vitamin D deficiency and total fatigue scores and chronic fatigue, respectively. The analyses were adjusted for age, gender, disease activity, depressive symptoms and sleep disturbance. RESULTS In total, 405 patients were included in the analyses, of which 227 (56%) had Crohn’s disease (CD) and 178 (44%) had ulcerative colitis (UC). Vitamin D deficiency (< 50 nmol/L) was present in half (203/405) of the patients. Chronic fatigue was reported by 116 (29%) of all included patients with substantial fatigue reported by 194 (48%). Vitamin D levels were neither associated with total fatigue nor with chronic fatigue. Higher total fatigue scores and chronic fatigue were both associated with increased disease activity scores in patients with UC and CD, but not with increased CRP or fecal calprotectin. In UC patients, female gender was associated with fatigue in the univariate analysis, but no such difference was found when adjusted for elevated disease activity scores. Sleep disturbance and more depressive symptoms were associated with total fatigue scores in both UC and CD patients, but with chronic fatigue only in CD patients. CONCLUSION In this study, no significant association between fatigue and vitamin D deficiency in IBD patients was revealed. Key Words: Inflammatory bowel disease, Crohn’s disease, Ulcerative colitis, Fatigue, Chronic fatigue, Vitamin D deficiency Core tip: Fatigue is common in inflammatory bowel diseases (IBD) and is especially prevalent in active disease. We wanted to investigate if vitamin D deficiency was associated to fatigue in IBD as this is a common belief among both patients and physicians. To the best of our knowledge, no previous studies have investigated this possible association in IBD patients. We also wanted to take into account the multidimensional approach in understanding fatigue making it difficult to single out any one contributing factor. In this study, no significant association between fatigue and vitamin D deficiency in IBD patients was revealed.

• Mohammed, Ahmed Kedir; Pedersen, Marius; Hovde, Øistein & Yayilgan, Sule Yildirim (2018). Deep-STRESS Capsule Video Endoscopy Image Enhancement. Color and Imaging Conference (CIC). ISSN 2166-9635. s. 247–252. doi: 10.2352/ISSN.2169-2629.2018.26.247. Fulltekst i vitenarkiv Vis sammendrag

  This paper proposes a unified framework for capsule video endoscopy image enhancement with an objective to enhance the diagnostic values of these images. The proposed method is based on a hybrid approach of deep learning and classical image processing techniques. Given an input image, it is decomposed spatially into multi-layer features. We estimate the base layer with pre-trained deep edge aware filters that are learned on the flicker dataset. The detail layers are estimated by the spatio-temporal retinex-inspired envelope with a stochastic sampling technique. The enhanced image is computed by a convex linear combination of the base and the detail layers giving detailed and shadow surface enhanced image. To show its potential, performance comparison between with and without the proposed image enhancement technique is shown using several video images obtained from capsule endoscopy for different parts of the digestive organ. Moreover, different learned filters such as Bilateral and Lo norm are compared for enhancement using an objective image quality metric, BRISQUE, to show the generality of the proposed method.

• Mohammed, Ahmed Kedir; Farup, Ivar; Yildirim, Sule; Pedersen, Marius & Hovde, Øistein (2018). Variational approach for capsule video frame interpolation. EURASIP Journal on Image and Video Processing. ISSN 1687-5176. 2018:30, s. 1–13. doi: 10.1186/s13640-018-0267-9. Fulltekst i vitenarkiv Vis sammendrag

  Capsule video endoscopy, which uses a wireless camera to visualize the digestive tract, is emerging as an alternative to traditional colonoscopy. Colonoscopy is considered as the gold standard for visualizing the colon and takes 30 frames per second. Capsule images, on the other hand, are taken with low frame rate (average five frames per second), which makes it difficult to find pathology and results in eye fatigue for viewing. In this paper, we propose a variational algorithm to smooth the video temporally and create a visually pleasant video. The main objective of the paper is to increase the frame rate to be closer to that of the colonoscopy. We propose variational energy that takes into consideration both motion estimation and intermediate frame intensity interpolation using the surrounding frames. The proposed formulation incorporates both pixel intensity and texture feature in the optical flow objective function such that the interpolation at the intermediate frame is directly modeled. The main feature of this formulation is that error in motion estimation is incorporated in our model, so that only robust motion estimation are used in estimating the intensity of the intermediate frame. We derived Euler-Lagrange equations and showed an efficient numerical scheme that can be implemented on graphics hardware. Finally, a motion compensated frame rate doubling version of our method is implemented. We evaluate the quality of both 90 and 100% of the frames for medical diagnosis domain through objective image quality metrics. Our method improves state-of-the-art result for 90% frames while performing equivalent for the remaining cases with other existing methods. In the last section, we show application of frame interpolation to informative frame segment visualization and to reduce the power consumption.

• Frigstad, Svein Oskar; Høivik, Marte; Jahnsen, Jørgen; Dahl, Sandra Rinne; Småstuen, Milada C & Grimstad, Tore [Vis alle 13 forfattere av denne artikkelen] (2017). Vitamin D deficiency in inflammatory bowel disease: Prevalence and predictors in a Norwegian outpatient population. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 52(1), s. 100–106. doi: 10.1080/00365521.2016.1233577. Fulltekst i vitenarkiv Vis sammendrag

  Background and aim: Vitamin D deficiency is common in inflammatory bowel disease (IBD). The aims of the present study were to determine the prevalence of vitamin D deficiency and to identify clinical and epidemiological variables associated with vitamin D deficiency in an outpatient population with IBD. Methods: Participants were recruited from nine hospitals in the southeastern and western regions of Norway as part of an observational, multicentre study from March 2013 to April 2014. Clinical and epidemiological data were collected by interview and from medical records. All analyses of serum 25-hydroxyvitamin D (25-OH-D) were performed in the same laboratory. Results: In total, 49% (200/408) of the patients had a 25-OH-D concentration <50 nmol/L, including 53% (122/230) of the Crohn’s disease (CD) patients and 44% (78/178) of the ulcerative colitis (UC) patients. In CD patients, disease activity, measured as the HBI, was inversely associated with vitamin D deficiency. No such association was observed with the Simple Clinical Colitis Activity Index (SCCAI) scores in UC, but in UC patients, vitamin D deficiency was associated with elevated faecal calprotectin >100 mg/kg. In patients with CD, there were significantly more relapses during the previous year in patients with vitamin D deficiency. Conclusions: Vitamin D deficiency was common, especially in CD, and was associated with increased disease activity, a relapsing disease course and higher inflammatory activity.

• Wåhlberg, Henrik; Valle, Per Christian; Malm, Siri; Hovde, Øistein & Broderstad, Ann Ragnhild (2017). The effect of referral templates on out-patient quality of care in a hospital setting: A cluster randomized controlled trial. BMC Health Services Research. 17:177, s. 1–13. doi: 10.1186/s12913-017-2127-1. Fulltekst i vitenarkiv Vis sammendrag

  Background The assessment of quality of care is an integral part of modern medicine. The referral represents the handing over of care from the general practitioner to the specialist. This study aimed to assess whether an improved referral could lead to improved quality of care. Methods A cluster randomized trial with the general practitioner surgery as the clustering unit was performed. Fourteen surgeries in the area surrounding the University Hospital of North Norway Harstad were randomized stratified by town versus countryside location. The intervention consisted of implementing referral templates for new referrals in four clinical areas: dyspepsia; suspected colorectal cancer; chest pain; and confirmed or suspected chronic obstructive pulmonary disease. The control group followed standard referral practice. Quality of treatment pathway as assessed by newly developed quality indicators was used as main outcome. Secondary outcomes included subjective quality assessment, positive predictive value of referral and adequacy of prioritization. Assessment of outcomes was done at the individual level. The patients, hospital doctors and outcome assessors were blinded to the intervention status. Results A total of 500 patients were included, with 281 in the intervention and 219 in the control arm. From the multilevel regression model the effect of the intervention on the quality indicator score was insignificant at 1.80% (95% CI, −1.46 to 5.06, p = 0.280). No significant differences between the intervention and the control groups were seen in the secondary outcomes. Active use of the referral intervention was low, estimated at approximately 50%. There was also wide variation in outcome scoring between the different assessors. Conclusions In this study no measurable effect on quality of care or prioritization was revealed after implementation of referral templates at the general practitioner/hospital interface. The results were hindered by a limited uptake of the intervention at GP surgeries and inconsistencies in outcome assessment.

• Mohammed, Ahmed Kedir; Yildirim, Sule; Pedersen, Marius; Hovde, Øistein & Cheikh, Faouzi Alaya (2017). Sparse coded handcrafted and deep features for colon capsule video summarization. Computer-Based Medical Systems. ISSN 1063-7125. 2017-June, s. 728–733. doi: 10.1109/CBMS.2017.13. Fulltekst i vitenarkiv Vis sammendrag

  Capsule endoscopy, which uses a wireless camera to take images of the digestive track, is emerging as an alternative to traditional wired colonoscopy. A single examination produces a sequence of approximately 50,000 frames. These sequences are manually reviewed, which is time consuming and typically takes about 45-90 minutes and requires the undivided concentration of the reviewer. In this paper, we propose a novel capsule video summarization framework using sparse coding and dictionary learning in feature space. Video frames are clustered into superframes based on power spectral density, and cluster representative frames are used for video summarization. Handcrafted and deep features that are extracted for representative frames are sparse coded using a learned dictionary. Sparse coded features are later used for training SVM classifier. The proposed method was compared with state-of-the-art methods based on sensitivity and specificity. The achieved results show that our proposed framework provides robust capsule video summarization without losing informative segments.

• Mohammed, Ahmed Kedir; Yildirim, Sule; Pedersen, Marius; Hovde, Øistein & Cheikh, Faouzi Alaya (2017). Sparse coded handcrafted and deep features for colon capsule video summarization, Computer-Based Medical Systems (CBMS), 2017 IEEE 30th International Symposium on. IEEE (Institute of Electrical and Electronics Engineers). ISSN 9781538617106. s. 728–733. doi: 10.1109/CBMS.2017.13. Fulltekst i vitenarkiv
• Huppertz-Hauss, Gert; Høivik, Marte; Jelsness-Jørgensen, Lars-Petter; Opheim, Randi; Henriksen, Magne & Høie, Ole Ingebreth [Vis alle 13 forfattere av denne artikkelen] (2017). Fatigue in a population-based cohort of patients with inflammatory bowel disease 20 years after diagnosis: The IBSEN study. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 52(3), s. 351–358. doi: 10.1080/00365521.2016.1256425. Fulltekst i vitenarkiv
• Rukundo, Olivier; Pedersen, Marius & Hovde, Øistein (2017). Advanced Image Enhancement Method for Distant Vessels and Structures in Capsule Endoscopy. Computational & Mathematical Methods in Medicine. ISSN 1748-670X. 2017, s. 1–13. doi: 10.1155/2017/9813165. Fulltekst i vitenarkiv Vis sammendrag

  This paper proposes an advanced method for contrast enhancement of capsule endoscopic images, with the main objective to obtain sufficient information about the vessels and structures in more distant (or darker) parts of capsule endoscopic images. The proposed method (PM) combines two algorithms for the enhancement of darker and brighter areas of capsule endoscopic images, respectively. The half-unit weighted-bilinear algorithm (HWB) proposed in our previous work is used to enhance darker areas according to the darker map content of its HSV’s component . Enhancement of brighter areas is achieved thanks to the novel threshold weighted-bilinear algorithm (TWB) developed to avoid overexposure and enlargement of specular highlight spots while preserving the hue, in such areas. The TWB performs enhancement operations following a gradual increment of the brightness of the brighter map content of its HSV’s component . In other words, the TWB decreases its averaged weights as the intensity content of the component increases. Extensive experimental demonstrations were conducted, and, based on evaluation of the reference and PM enhanced images, a gastroenterologist (Ø.H.) concluded that the PM enhanced images were the best ones based on the information about the vessels, contrast in the images, and the view or visibility of the structures in more distant parts of the capsule endoscopy images.

• Jelsness-Jørgensen, Lars-Petter; Moum, Bjørn; Grimstad, Tore; Jahnsen, Jørgen; Opheim, Randi & Berset, Ingrid Prytz [Vis alle 11 forfattere av denne artikkelen] (2016). Validity, reliability, and responsiveness of the brief pain inventory in inflammatory bowel disease. Canadian Journal of Gastroenterology and Hepatology. ISSN 2291-2789. 2016:5624261. doi: 10.1155/2016/5624261. Fulltekst i vitenarkiv
• Eskeland, Sigrun Losada; Brunborg, Cathrine; Seip, Birgitte Karen Berggreen; Wiencke, Kristine; Hovde, Øistein & Owen, Tanja [Vis alle 12 forfattere av denne artikkelen] (2016). First quality score for referral letters in gastroenterology—a validation study. BMJ Open. 6(10). doi: 10.1136/bmjopen-2016-012835. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Objective To create and validate an objective and reliable score to assess referral quality in gastroenterology. Design An observational multicentre study. Setting and participants 25 gastroenterologists participated in selecting variables for a Thirty Point Score (TPS) for quality assessment of referrals to gastroenterology specialist healthcare for 9 common indications. From May to September 2014, 7 hospitals from the South-Eastern Norway Regional Health Authority participated in collecting and scoring 327 referrals to a gastroenterologist. Main outcome measure Correlation between the TPS and a visual analogue scale (VAS) for referral quality. Results The 327 referrals had an average TPS of 13.2 (range 1–25) and an average VAS of 4.7 (range 0.2–9.5). The reliability of the score was excellent, with an intra-rater intraclass correlation coefficient (ICC) of 0.87 and inter-rater ICC of 0.91. The overall correlation between the TPS and the VAS was moderate (r=0.42), and ranged from fair to substantial for the various indications. Mean agreement was good (ICC=0.47, 95% CI (0.34 to 0.57)), ranging from poor to good. Conclusions The TPS is reliable, objective and shows good agreement with the subjective VAS. The score may be a useful tool for assessing referral quality in gastroenterology, particularly important when evaluating the effect of interventions to improve referral quality.

• Jelsness-Jørgensen, Lars-Petter; Bernklev, Tomm; Hovde, Øistein; Berset, Ingrid Prytz; Huppertz-Hauss, Gert & Moum, Bjørn [Vis alle 7 forfattere av denne artikkelen] (2016). Patients’ perceptions of quality of care and follow-up in inflammatory bowel disease. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 51(4), s. 434–441. doi: 10.3109/00365521.2015.1102319. Fulltekst i vitenarkiv
• Kapica, Aida; Hov, Johannes Espolin Roksund; Borthne, Arne Sigmund; Gleditsch, Jostein; Johannesen, Glenn & Tveit, Knut [Vis alle 19 forfattere av denne artikkelen] (2016). Prevalence of Sclerosing Cholangitis Detected by Magnetic Resonance Cholangiography in Patients With Long-term Inflammatory Bowel Disease. Gastroenterology. ISSN 0016-5085. 151(4), s. 660–669. doi: 10.1053/j.gastro.2016.06.021. Fulltekst i vitenarkiv
• Wanderås, Magnus; Moum, Bjørn; Høivik, Marte Lie & Hovde, Øistein (2016). Predictive factors for a severe clinical course in ulcerative colitis: Results from population-based studies. World Journal of Gastrointestinal Pharmacology and Therapeutics (WJGPT). 7(2), s. 235–241. doi: 10.4292/WJGPT.v7.i2.235. Fulltekst i vitenarkiv
• Hovde, Øistein; Høivik, Marte Lie; Henriksen, Magne; Solberg, Inger Camilla; Småstuen, Milada Cvancarova & Moum, Bjørn A (2016). Malignancies in Patients with Inflammatory Bowel Disease: Results from 20 Years of Follow-up in the IBSEN Study. Journal of Crohn's and Colitis. ISSN 1873-9946. doi: 10.1093/ecco-jcc/jjw193. Fulltekst i vitenarkiv Vis sammendrag

  Background and Aims: Whether patients with inflammatory bowel diseases [IBDs] have increased risk of developing cancer has been debated. The aims of the study were to determine the prevalence of intestinal/extraintestinal cancers in an IBD cohort 20 years after diagnosis and to assess whether these patients had an increased cancer-specific risk compared with a matched control population. Methods: Patients with ulcerative colitis [UC] and Crohn′s disease [CD] diagnosed 1990–1993 have been prospectively followed up for 20 years. Follow-up visits were carried out 1, 5, 10, and 20 years after inclusion. Data on all cancer cases, deaths, and causes of death were collected from the Cancer Registry of Norway and from the Norwegian Cause of Death Registry. Results: In all, 756 patients [519 UC and 237 CD] were diagnosed with IBD. Increased risk of cancer was seen in UC patients (hazard ratio [HR] = 1.40, 95% confidence interval [CI] 1.08–1.81, p < 0.01), but not in CD patients [HR = 1.23, 95% CI 0.80–2.03, p = 0.30]. Stratified by gender, our data revealed a statistically increased risk for all cancers only in male UC patients compared with the controls [HR = 1.51, 95% CI 1.08–2.11, p = 0.017]. In both groups breast cancer was seen more often than expected. Conclusions: Male UC patients display an increased risk of development of colorectal cancer and, also all cancers combined, compared with the controls. In both UC and CD, standardized incidence ratio for breast cancer was increased.

• Hovde, Øistein; Småstuen, Milada C; Høivik, Marte; Bernklev, Tomm; Huppertz-Hauss, Gert & Høie, Ole Ingebreth [Vis alle 11 forfattere av denne artikkelen] (2016). Mortality and Causes of Death in Ulcerative Colitis: Results from 20 Years of Follow-up in the IBSEN Study. Inflammatory Bowel Diseases. ISSN 1078-0998. 22(1), s. 141–145. doi: 10.1097/MIB.0000000000000582. Fulltekst i vitenarkiv
• Hovde, Øistein; Huppertz-Hauss, Gert; Høivik, Marte & Moum, Bjørn (2014). Clinical course, treatment strategies, social and economic impact of Ulcerative Colitis: An overview. Austin Journal of Gastroenterology. ISSN 2381-9219. 1(4), s. 1–9. Fulltekst i vitenarkiv
• Moum, Bjørn; Hovde, Øistein & Høivik, Marte (2014). What have we learnt about the role of the environment and natural course of IBD in the new millennium? 20-year follow-up of the IBSEN cohort. Digestive Diseases. ISSN 0257-2753. 32, s. 2–9. doi: 10.1159/000367818. Fulltekst i vitenarkiv Vis sammendrag

  The incidence and prevalence of IBD, both Crohn's disease (CD) and ulcerative colitis (UC), have increased in recent years, especially in industrialized countries. Still, the etiology of IBD remains largely unknown. Most research on IBD before the 1990s was conducted on selected patient populations. Selected patient populations are likely to introduce important bias and limit the interpretation and generalizability. The inclusion of both incident and prevalent cases or the inclusion of incident cases over long periods of time (decades) might also introduce bias due to changes in treatment regimens and socioeconomic factors over timer (time-trend bias). Consequently, the choice of a well-characterized population-based inception cohort provides the best opportunity to describe the natural course of a disease. The IBSEN (Inflammatory Bowel Disease in South-Eastern Norway) study followed a large population-based cohort of newly diagnosed IBD patients for 20 years and has contributed significantly to the knowledge of the natural course of IBD.

• Kempski-Monstad, Iril Lovise; Hovde, Øistein; Solberg, Inger Camilla & Moum, Bjørn (2014). Clinical course and prognosis in ulcerative colitis: Results from population-based and observational studies. Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology.. ISSN 1108-7471. 27(2), s. 95–104. Fulltekst i vitenarkiv Vis sammendrag

  The clinical course of ulcerative colitis (UC) may range from a quiescent course with prolonged periods of remission to fulminant disease requiring intensive medical treatment or surgery. Disease outcome is often determined by relapse rates, the development of colorectal cancer (CRC) and mortality rates. Early patient classification, identifying those with a high risk of developing complicated disease, is essential for choosing appropriate treatment. This paper reviews the clinical outcomes of UC patients as reported in population-based and observational studies representative of the whole patient population. Extensive colitis, a high level of systemic symptoms and young age at diagnosis are factors associated with a high risk of colectomy. Patients with distal disease who progress to extensive colitis seem to be a subgroup with an especially high risk of colectomy. Some prognostic factors of severe disease have been identified which could be used to optimize treatment and possibly reduce future complications. The overall risk of CRC and mortality was not significantly different from that of the background population. These results may have implications for follow-up strategies, especially regarding endoscopic surveillance of UC patients.

• Hovde, Øistein; Lie, Øyvind Haugen; Johansson, Per A; Stubhaug, Øystein; Johnson, Egil & Hofstad, Bjørn [Vis alle 7 forfattere av denne artikkelen] (2013). Iatrogenic esophago-tracheal fistula: Challenges in diagnosis and management. World Journal of Gastroenterology (WJG). ISSN 1007-9327. 19(4), s. 594–596. doi: 10.3748/wjg.v19.i4.594. Fulltekst i vitenarkiv
• Hovde, Øistein; Kempski-Monstad, Iril Lovise; Småstuen, Milada Cvancarova; Solberg, Inger Camilla; Henriksen, Magne & Jahnsen, Jørgen [Vis alle 8 forfattere av denne artikkelen] (2013). Mortality and causes of death in Crohn's disease: Results from 20 years of follow-up in the IBSEN study. Gut. ISSN 0017-5749. 63(5), s. 771–775. doi: 10.1136/gutjnl-2013-304766. Fulltekst i vitenarkiv
• Larssen, Lene; Medhus, Asle Wilhelm; Kørner, Hartwig; Glomsaker, Tom Birger; Søberg, Taran & Gleditsch, Dagfinn [Vis alle 11 forfattere av denne artikkelen] (2012). Long-term outcome of palliative treatment with self-expanding metal stents for malignant obstructions of the GI tract. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. 47(12), s. 1505–1514. doi: 10.3109/00365521.2012.711854. Fulltekst i vitenarkiv
• Hovde, Øistein & Moum, Bjørn (2012). Epidemiology and clinical course of Crohn's disease: Results from observational studies. World Journal of Gastroenterology (WJG). ISSN 1007-9327. 18(15), s. 1723–1731. doi: 10.3748/wjg.v18.i15.1723. Fulltekst i vitenarkiv
• Larssen, Lene; Medhus, Asle Wilhelm; Hjermstad, Marianne Jensen; Kørner, Hartwig; Glomsaker, Tom & Søberg, Taran [Vis alle 12 forfattere av denne artikkelen] (2011). Patient-reported outcomes in palliative gastrointestinal stenting: a Norwegian multicenter study. Surgical Endoscopy. ISSN 0930-2794. 25(10), s. 3162–3169. doi: 10.1007/s00464-011-1680-7. Fulltekst i vitenarkiv Vis sammendrag

  Background The clinical effect of stent treatment has been evaluated by mainly physicians; only a limited number of prospective studies have used patient-reported outcomes for this purpose. The aim of this work was to study the clinical effect of self-expanding metal stents in treatment of malignant gastrointestinal obstructions, as evaluated by patient-reported outcomes, and compare the rating of the treatment effect by patients and physicians. Methods Between November 2006 and April 2008, 273 patients treated with SEMS for malignant GI and biliary obstructions were recruited from nine Norwegian hospitals. Patients and physicians assessed symptoms independently at the time of treatment and after 2 weeks using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire supplemented with specific questions related to obstruction. Results A total of 162 patients (99 males; median age = 72 years) completed both assessments and were included in the study. A significant improvement in the mean global health score was observed after 2 weeks (from 9 to 18 on a 0–100 scale, P\0.03) for all stent locations. Both patients and physicians reported a significant reduction in all obstruction-related symptoms ([20 on the 0–100 scale, P\0.006) after SEMS treatment. The physicians reported a larger mean improvement in symptoms than did the patients, mainly because they reported more severe symptoms before treatment. Conclusion SEMS treatment is effective in relieving symptoms of malignant GI and biliary obstruction, as reported by patients and physicians. The physicians, however, reported a larger reduction in obstructive symptoms than did the patients. A prospective assessment of patientreported outcomes is important in evaluating SEMS treatment.

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• Maseng, Maria Gjerstad; Hansen, S Hyll; Bang, Corina; Valeur, Jørgen; Huppertz-Hauss, Gert & Opheim, Randi [Vis alle 18 forfattere av denne artikkelen] (2025). Longitudinal Changes in Gut Microbiota During the First Year following diagnosis of Inflammatory Bowel Disease – the IBSEN III study. Journal of Crohn's and Colitis. ISSN 1873-9946. 19, s. i2387–i2387. doi: 10.1093/ecco-jcc/jjae190.1498. Fulltekst i vitenarkiv
• Maseng, Maria Gjerstad; Hansen, Simen Hyll; Bang, Corina; Valeur, Jørgen; Huppertz-Hauss, Gert & Opheim, Randi [Vis alle 18 forfattere av denne artikkelen] (2025). Longitudinal Changes in Gut Microbiota During the First Year following diagnosis of Inflammatory Bowel Disease – the IBSEN III study. Fulltekst i vitenarkiv
• Maseng, Maria Gjerstad; Hansen, Simen Hyll; Bang, Corina; Detlie, Trond Espen; Huppertz-Hauss, Gert & Kristensen, Vendel Ailin [Vis alle 18 forfattere av denne artikkelen] (2024). Longitudinal Changes in Gut Microbiota During the First Year following diagnosis of Inflammatory Bowel Disease– the IBSEN III study. Fulltekst i vitenarkiv
• Hansen, Simen Hyll; Maseng, M Gjerstad; Bjørkqvist, O; Halfvarsson, J; Bang, C & Detlie, Trond Espen [Vis alle 23 forfattere av denne artikkelen] (2023). Gut microbiota at diagnosis is associated with clinical features and future disease course in Inflammatory Bowel Disease: Data from IBSEN III, a new large Norwegian population-based inception cohort. Journal of Crohn's and Colitis. ISSN 1873-9946. 17, s. i1028–I2029. doi: 10.1093/ecco-jcc/jjac190.1050. Fulltekst i vitenarkiv
• Vats, Anuja & Hovde, Øistein (2023). Can we distinguish between real and artificial image from colon capsules? Fulltekst i vitenarkiv
• Strande, Vibeke; Småstuen, Milada C.; Lund, Charlotte; Bengtson, May-Bente; Høie, Ole & Cetinkaya, Raziye Boyar [Vis alle 26 forfattere av denne artikkelen] (2022). Klinisk karakteristika hos nydiagnostiserte pasienter med inflammatorisk tarmsykdom - resultater fra IBSEN III-studien. Fulltekst i vitenarkiv
• Strande, Vibeke; Småstuen, Milada C; Huppertz-Hauss, Gert; Perminow, Gøri; Henriksen, Magne & Bengtson, May-Bente [Vis alle 17 forfattere av denne artikkelen] (2022). Fecal calprotectin at diagnosis is associated with oral steroid use first year of inflammatory bowel disease. Fulltekst i vitenarkiv
• Strande, Vibeke; Småstuen, Milada C.; Hasund, Audun; Huppertz-Hauss, Gert; Pallenschat, Jens & Bengtson, May-Bente [Vis alle 18 forfattere av denne artikkelen] (2021). Clinical characteristics associated with biochemical remission three months after diagnosis of ulcerative colitis. Fulltekst i vitenarkiv
• Strande, Vibeke; Småstuen, Milada C.; Hasund, Audun; Huppertz-Hauss, Gert; Pallenschat, Jens & Bengtson, May-Bente [Vis alle 18 forfattere av denne artikkelen] (2021). Clinical characteristics associated with biochemical remission three months after diagnosis of Crohn's disease. Fulltekst i vitenarkiv
• Kristensen, Vendel Ailin; Lund, Charlotte; Opheim, Randi; Ricanek, Petr; Huppertz-Hauss, Gert & Perminow, Gøri Margrete [Vis alle 37 forfattere av denne artikkelen] (2020). Inflammatory Bowel Disease in South-Eastern Norway III – IBSEN III. Fulltekst i vitenarkiv
• Opheim, Randi; Bernklev, Tomm; Jahnsen, Jørgen; Grimstad, Tore; Hovde, Øistein & Berset, Ingrid Prytz [Vis alle 8 forfattere av denne artikkelen] (2018). Chronic fatigue in patients with inflammatory bowel disease is associated with lower health–related quality of life, low self-esteem, increased anxiety and depression. Fulltekst i vitenarkiv
• Mohammed, Ahmed Kedir; Yayilgan, Sule Yildirim; Farup, Ivar; Pedersen, Marius & Hovde, Øistein (2018). Y-Net: A deep convolutional neural network to polyp detection. Fulltekst i vitenarkiv
• Kedir, Ahmed; Yayilgan, Sule Yildirim; Farup, Ivar; Pedersen, Marius & Hovde, Øistein (2018). Y-net: A deep convolutional neural network for polyp detection. https://arxiv.org/abs/1806.01907. Fulltekst i vitenarkiv
• Frigstad, Svein Oskar; Bernklev, Tomm; Dahl, Sandra Rinne; Hovde, Øistein; Jahnsen, Jørgen & Grimstad, Tore [Vis alle 10 forfattere av denne artikkelen] (2017). Vitamin D deficiency is not associated with chronic fatigue in inflammatory bowel disease. Fulltekst i vitenarkiv
• Frigstad, Svein Oskar; Høivik, Marte Lie; Småstuen, Milada C; Jahnsen, Jørgen; Dahl, Sandra Rinne & Berset, Ingrid Prytz [Vis alle 13 forfattere av denne artikkelen] (2017). Fatigue er ikke assosiert med vitamin D mangel hos IBD pasienter. Fulltekst i vitenarkiv
• Frigstad, Svein Oskar; Høivik, Marte Lie; Moum, Bjørn; Dahl, Sandra Rinne; Jahnsen, Jørgen & Småstuen, Milada Cvancarova [Vis alle 12 forfattere av denne artikkelen] (2017). Vitamin D deficiency is not associated with depression in IBD patients. Fulltekst i vitenarkiv
• Hovde, Øistein; Høivik, Marte Lie; Henriksen, Magne; Solberg, Inger Camilla; Småstuen, Milada Cvancarova & Moum, Bjørn Allan (2017). Corrigendum: Malignancies in Patients with Inflammatory Bowel Disease (IBD): Results from 20 Years of Follow-up in the IBSEN (Inflammatory Bowel South-Eastern Norway) Study. Journal of Crohn's and Colitis. ISSN 1873-9946. 11(12), s. 1511–1511. doi: 10.1093/ecco-jcc/jjw218. Fulltekst i vitenarkiv
• Frigstad, Svein Oskar; Høivik, Marte Lie; Jahnsen, Jørgen; Dahl, Sandra Rinne; Cvancarova, Milada & Grimstad, Tore [Vis alle 13 forfattere av denne artikkelen] (2017). Vitamin D deficiency is not associated with depression in IBD patients. Journal of Crohn's and Colitis. ISSN 1873-9946. 11, s. 444–445. doi: 10.1093/ecco-jcc/jjx002.834. Fulltekst i vitenarkiv
• Hovde, Øistein & Skotte, Kjetil (2017). Menn med ulcerøs colitt dør ikke oftere av kreft. Forskning.no. ISSN 1891-635X. Fulltekst i vitenarkiv
• Frigstad, Svein Oskar; Høivik, Marte Lie; Jahnsen, Jørgen; Småstuen, Milada C; Grimstad, Tore & Berset, Ingrid Prytz [Vis alle 12 forfattere av denne artikkelen] (2017). Fatigue is not Associated with Vitamin D Deficiency in IBD Patients. Gastroenterology. ISSN 0016-5085. 152(5), s. S945–S945. doi: 10.1016/S0016-5085(17)33218-3. Fulltekst i vitenarkiv
• Jelsness-Jørgensen, Lars-Petter; Høivik, Marte Lie; Moum, Bjørn; Opheim, Randi; Huppertz-Hauss, Gert & Grimstad, Tore [Vis alle 10 forfattere av denne artikkelen] (2015). Fatigue is associated with increased pain intensity and interference in IBD. Inflammatory Bowel Diseases. ISSN 1078-0998. doi: 10.1080/00365521. Fulltekst i vitenarkiv
• Hovde, Øistein & Moum, Bjørn (2013). Langtidsoppfølging av pasienter med Crohns sykdom - IBSEN-studien finner bedre progose enn tidligere antatt. BestPractice. 9, s. 7–9. Fulltekst i vitenarkiv
• Hovde, Øistein (2013). Gjøviklege med ny forskning - Vekker oppsikt. [Journal]. Oppland Arbeiderblad. Fulltekst i vitenarkiv
• Hovde, Øistein (2016). Clinical outcome of inflammatory bowel disease with special emphasis on mortality and cancer development. The IBSEN study. Universitetet i Oslo. Fulltekst i vitenarkiv

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