Su1819 THE EFFECTIVENESS OF A STANDARDIZED BIOLOGIC CARE PATHWAY IN THE MANAGEMENT AND TREATMENT OF INFLAMMATORY BOWEL DISEASE Natalie Willett, Courtney Heisler, Nancy Nazer, Barbara Currie, Kelly Phalen-Kelly, Michael Stewart, Jennifer L. Jones Background: Inflammatory Bowel Disease (IBD) is a class of chronic immune-mediated diseases. Biologics have revolutionized the treatment of IBD. Existing literature suggests significant variation exists in the use of biologic treatment among physicians, from provider- specific prescribing to completion of the pre-biologic workup. These differences may influ- ence the effectiveness of achieving and maintaining long-term remission. Clinical care path- ways may serve to standardize the use of biologics in the treatment of IBD leading to improvements in patient outcomes and consistency of the care provided from different specialists. Aims: To determine if the use of biologics to treat IBD managed within a standardized biologic care pathway (BCP) is safer and more effective compared to the current standard of care. Methods: This was a retrospective, real-world cohort study of a prospectively implemented evidence-based BCP at the Nova Scotia Collaborative IBD (NSCIBD) program between 2015 and 2019. Patient inclusion criteria consisted of any adult with a diagnosis of IBD (including Crohn’s Disease, ulcerative colitis, IBD- Unclassified) aged 18 years or older who was managed within the NSCIBD program. Preliminary descriptive analyses of the data are presented. Data collection is ongoing and multivariate analyses will be presented in full at CDDW. Results : In total 249 patients were included in the cohort study (111 BCP patients, 138 non-BCP patients). The mean age was 49 years (range of 17-86 years). Sixty-nine percent (171/249) of patients were diagnosed with CD, 28% (70/249) with UC, and 3% (8/249) with IBD-U. The mean duration of disease was 13 years (range of 0-36 years). Use of combination therapy was similar between the cohorts with 64% of BCP patients (n=102) and 63% of non-BCP patients (n=123) on combination therapy. Thirty- eight percent of the BCP cohort required dosing interval changes vs. 29% in the non-BCP cohort (0.24 fold higher in BCP cohort). Seventy-one percent of the BCP patients were exposed to TDM vs. 41% of the non-BCP cohort (0.40-fold more TDM in pathway cohort). Although 34% of BCP patients and 38% of non-BCP cohort patients reached clinical remission (n=103 and 125 respectively), 38% of BCP patients and 21% of non-BCP patients achieved endoscopic remission (0.5-fold lower in the non-BCP cohort), (n=29 and 53, respectively). Conclusions: Preliminary analyses suggest patients managed within a BCP have their biologic management guided more often by the results of TDM and objective biomarkers than those not managed within a BCP. Although clinical remission was observed to be similar between the cohorts, attainment of endoscopic remission was more likely amongst patients managed within the BCP. Additional multivariate analyses will be presented at CDDW with a larger cohort size. S-661 AGA Abstracts Su1820 A SYSTEMATIC REVIEW: ARE THE QUALITY METRICS IN INFLAMMATORY BOWEL DISEASE PROPOSED BY PROFESSIONAL GASTROENTEROLOGY AND INFLAMMATORY BOWEL DISEASE ORGINIZATIONS ROOTED ON SUBSTANTIAL QUALITY EVIDENCE? Simcha Weissman, Alexander Goldowsky, Tej I. Mehta, Michael Sciarra, Joseph D. Feuerstein Background: Quality indicators (QIs) or metrics were established to develop standards by which the quality of care can be assessed on both a national and international level. While all QIs serve to achieve a standard of care, there is still a major variation in clinical practice and not all facilities have adapted these metrics. To this end we performed a systematic review to assess the overall quality of evidence cited in formulating these quality metrics. Methods: A systematic search was performed on PubMed and EMBASE using Mesh terms such as; “IBD”, “UC”, “CD, “quality indicators” and “quality metrics”, in October 2019. The following societies were ultimately included in the final analysis: American College of Gastroenterology (ACG), Crohn’s and Colitis Foundation of America (CCFA), Canadian Emerging Practice in IBD Collaborative (Canada EPIC), Choosing Wisely Canada, Interna- tional Consortium for Health Outcomes Measurement (ICHOM), the Spanish Working Group (GETECCU), and the Center for Medicare and Medicaid Services Merit-Based Incentive Payment System (MIPS/MACRA). A total of 86 distinct, and an aggregate total of 119 quality metrics were included in the final systematic review. Quality metrics were assessed for evidence quality and categorized as category A (guideline based), category B (primarily retrospective and observational studies), or category C (expert opinion). Quality metrics were examined for the type of metric, the quality, measurability, review, existing conflict of interest (COI), and patient participation of the metric. Statistical analysis was conducted in R using ANOVA, linear regression and chi-square or Kruskal-Wallis tests. Results: Our study indicated that 58% of IBD quality metrics, proposed by national and international IBD and gastroenterology societies, were based on low quality evidence, 4.2 % were based on moderate quality evidence, and 37.8% were based on high quality evidence as per our A, B, C category system (Table 1). The proportion of high-quality evidence across societies was significantly different (P <0.01). Additionally, only four organizations included patients in the development of their quality metrics, only one reported external review of their quality metrics, and not all of the recommendations reported measurable/quantifiable outcomes or directly resulted in patient outcomes. Moreover, only three organizations stated the presence of any COI. Finally, the majority of quality metrics (53%) were published in 2014, and none were published in the years 2012, 2015 and 2018 (Figure 1). Conclusion: As less then 40% of quality metrics were actually guideline-based evidence, the need for improving the development of quality metrics in IBD is paramount. The wide range in quality of evidence surrounding quality metrics by the various societies is illustrated. Category A represents high quality of evidence—namely based on published clinical practice guidelines. Category B represents moderate quality of evidence—namely based on prior studies cited in quality metrics. While category C represents low quality of evidence—namely based only on expert opinion. The distribution of graded evidence quality by the year the metric was published is illustrated. As shown, between the years of 2013 and 2016, the overwhelming majority of quality metrics were based on low quality evidence; additionally, quality metrics were not published in years 2012, 2015, and 2018. Su1821 SAME-PAGE CARE IS ASSOCIATED WITH IMPROVED SHARED DECISION- MAKING FOR PATIENTS WITH INFLAMMATORY BOWEL DISEASE Aricca Van Citters, Megan Holthoff, Alice M. Kennedy, Brant J. Oliver, Amanda L. Hoggard, Alandra Weaver, Corey A. Siegel, Gil Melmed, Eugene Nelson Background: Coproduction – the shared work of patients and clinicians to optimize health – is seen as increasingly important, yet little is known about tools to elicit and share the expertise both bring. We developed a novel e-health dashboard to facilitate coproduction in the adult inflammatory bowel disease (IBD) community. It uses an electronic pre-visit survey (PVS) to collect patient-reported outcomes (PROs) prior to a clinic visit (e.g., symp- toms, well-being, concerns, urgent care visits). PROs are coupled with data from the clinician AGA Abstracts