{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T13:32:39Z","timestamp":1793194359380,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["RS\u20102024\u201000509257"],"award-info":[{"award-number":["RS\u20102024\u201000509257"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["IITP\u20102026\u2010RS\u20102024\u201000438239"],"award-info":[{"award-number":["IITP\u20102026\u2010RS\u20102024\u201000438239"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008903","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["RS\u20102025\u201002220492"],"award-info":[{"award-number":["RS\u20102025\u201002220492"]}],"id":[{"id":"10.13039\/100008903","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Early prediction of treatment course in pediatric Crohn's disease (CD) remains limited despite the importance of timely biologic therapy. We developed and externally validated a multimodal model integrating colonoscopy images and clinical data to predict infliximab initiation within 6 months after conventional therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We collected data from children newly diagnosed with CD at three hospitals: Seoul National University Bundang Hospital for internal validation, Kyung Hee University Medical Center, and Soonchunhyang University Bucheon Hospital for external validation. Each patient contributed 7 endoscopic images and 20 clinical variables. An attention\u2010based multiple\u2010instance learning framework aggregated endoscopic images into a patient\u2010level representation and integrated them with clinical features. The imaging encoder used a ResNet\u201050 backbone pretrained with momentum contrastive learning on GastroNet\u20105M, and clinical features were encoded using a multilayer perceptron. Performance was assessed using the area under the receiver operating characteristic curve (AUROC), balanced accuracy, precision, recall, and F1 score. Explainable AI was evaluated using attention maps (image data) and SHAP values (tabular data).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy\u2010seven children were included for model development and internal validation, with external validation performed in two independent cohorts (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910 and\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920). The multimodal model achieved an AUROC of 0.839 and balanced accuracy of 0.732 in the discovery cohort. External\u2010validation AUROCs were 0.857 and 0.688. SHapley Additive exPlanation analysis identified immunoglobulin G, body mass index, prealbumin, hematocrit, and age as key predictors. Attention maps highlighted inflamed mucosa and ulcerative lesions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A multimodal model integrating colonoscopy images with clinical data showed promising performance for predicting infliximab initiation within 6 months after conventional therapy in pediatric CD. Multimodal information may support early risk stratification and identify patients who could benefit from earlier biologic intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70602","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:20:23Z","timestamp":1792131623000},"source":"Crossref","is-referenced-by-count":0,"title":["Multimodal prediction of infliximab initiation within 6 months after initiation of conventional therapy in pediatric Crohn's disease: A multicenter algorithm development and validation study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6433-0242","authenticated-orcid":false,"given":"Seon Young","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Kyung Hee University Medical Center Kyung Hee University School of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Ha","family":"Hwang","sequence":"additional","affiliation":[{"name":"Center for Digital Health, Medical Science Research Institute Kyung Hee University Medical Center, Kyung Hee University College of Medicine  Seoul South Korea"},{"name":"Department of Electronics and Information Convergence Engineering Kyung Hee University  Yongin South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongjin","family":"Yeo","sequence":"additional","affiliation":[{"name":"Center for Digital Health, Medical Science Research Institute Kyung Hee University Medical Center, Kyung Hee University College of Medicine  Seoul South Korea"},{"name":"Department of Medicine Kyung Hee University College of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juyeong","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Digital Health, Medical Science Research Institute Kyung Hee University Medical Center, Kyung Hee University College 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Bucheon Hospital  Bucheon Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7961-2074","authenticated-orcid":false,"given":"Selin","family":"Woo","sequence":"additional","affiliation":[{"name":"Center for Digital Health, Medical Science Research Institute Kyung Hee University Medical Center, Kyung Hee University College of Medicine  Seoul South Korea"},{"name":"Department of Medicine Kyung Hee University College of Medicine  Seoul South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6331-1314","authenticated-orcid":false,"given":"Jong Woo","family":"Hahn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Seoul National University College of Medicine  Seoul South Korea"},{"name":"Department of Pediatrics Seoul National University Bundang Hospital  Seongnam South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1628-9948","authenticated-orcid":false,"given":"Dong Keon","family":"Yon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kyung Hee University Medical Center Kyung Hee University School of Medicine  Seoul South Korea"},{"name":"Center for Digital Health, Medical Science Research Institute Kyung Hee University Medical Center, Kyung Hee University College of Medicine  Seoul South Korea"},{"name":"Department of Electronics and Information Convergence Engineering Kyung Hee University  Yongin South Korea"},{"name":"Department of Medicine Kyung Hee University College of Medicine  Seoul South Korea"},{"name":"Department of Regulatory Science Kyung Hee University  Seoul South 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