Monday, January 13, 2014

Celiac Disease: How Well Does a Symptom-Based Screening Questionnaire Detect It?

We recognize that the definitive test for celiac disease is an intestinal biopsy, but who needs that test, and can those who might benefit the most be identified simply by their symptoms?

Photo by Samir via Wikimedia Commons
Rosen et al. (doi: 10.1542/peds.2012-3765) investigated this question by looking at the frequency of symptoms and associated conditions unique to those with biopsy confirmed celiac disease and those without the disease. The authors used a population-based screening of 12-year-olds, who along with their parents, filled out a questionnaire asking about celiac disease-associated conditions.

Unfortunately, the sensitivity and specificity of symptoms for those who screened positive leaves much more to be desired—suggesting that the ability to diagnose celiac purely by symptomatology is not the gold standard and will miss a number of patients who also have this disorder without the classic symptoms.

The study results are tough to digest if one has previously considered celiac screening solely on the basis of classic symptoms and raise the question of whether or not a different set of questions might be needed to not miss as many cases as were missed in this study by the use of the questionnaire. Learn more about diagnosing children with celiac disease by reading this article.

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