Evidence map›Paper›PMID 30592070›Full record

ArticleAlimentary pharmacology & therapeutics2019

Serology-based criteria for adult coeliac disease have excellent accuracy across the range of pre-test probabilities.

Valma Fuchs, Kalle Kurppa, Heini Huhtala, Kaija Laurila, Markku Mäki, Pekka Collin, Teea Salmi, Liisa Luostarinen, Päivi Saavalainen, Katri Kaukinen

Open access · greenAbstract read
PubMed Publisher
In one paragraph

Article in Alimentary pharmacology & therapeutics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 1 pooled it
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 1 synthesis or guideline pooled it, 93 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. Non-biopsy Strategy for the Diagnosis of Celiac Disease in Adults: A Narrative Review.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2024
    Review
  8. Article
  9. Article
  10. Article
  11. The role of serology in the diagnosis of coeliac disease.Gastroenterology and hepatology from bed to bench · 2023
    Review
  12. No-biopsy diagnostic approach to coeliac disease.Gastroenterology and hepatology from bed to bench · 2023
    Review
  13. Article
  14. Article
  15. Article
  16. Observational
  17. The global burden of coeliac disease: opportunities and challenges.Nature reviews. Gastroenterology & hepatology · 2022
    Review
  18. Impact of COVID-19 pandemic on pediatric endoscopy: A multicenter study on behalf of the SIGENP Endoscopy Working Group.Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2022
    Article
  19. Celiac Disease Revisited.GE Portuguese journal of gastroenterology · 2022
    Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Valma FuchsCeliac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
Kalle KurppaTampere Center for Child Health Research, University of Tampere, and Department of Paediatrics, Tampere University Hospital, Tampere, Finland.ORCID 0000-0003-4757-2164
Heini HuhtalaTampere Faculty of Social Sciences, University of Tampere, Tampere, Finland.
Kaija LaurilaCeliac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
Markku MäkiTampere Center for Child Health Research, University of Tampere, and Department of Paediatrics, Tampere University Hospital, Tampere, Finland.
Pekka CollinDepartment of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.ORCID 0000-0002-4872-0416
Teea SalmiCeliac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
Liisa LuostarinenDepartment of Neurology, Päijät-Häme Central Hospital, Lahti, Finland.
Päivi SaavalainenResearch Programs Unit, Immunobiology, and Haartman Institute, Department of Medical Genetics, University of Helsinki, Helsinki, Finland.
Katri KaukinenCeliac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
Tampere University · FITampere University Hospital · FIPäijät-Hämeen Keskussairaala · FIUniversity of Helsinki · FI

Funding

Academy of FinlandCompetitive State Research Financing of the Expert Area of Tampere University HospitalFinnish Medical FoundationFoundation for Paediatric ResearchPäivikki and Sakari Sohlberg FoundationSigrid Juselius Foundation
6 · The paper itself

Abstract

backgroundThe revised paediatric criteria for coeliac disease allow omission of duodenal biopsies in symptomatic children who have specific serology and coeliac disease-associated genetics. It remains unclear whether this approach is also applicable for adults with various clinical presentations.

aimTo evaluate the accuracy of serology-based criteria in adults with variable pre-test probabilities for coeliac disease.

methodsThree study cohorts comprised adults with high-risk clinical coeliac disease suspicion (n = 421), moderate-risk family members of coeliac disease patients (n = 2357), and low-risk subjects from the general population (n = 2722). Serological and clinical data were collected, and "triple criteria" for coeliac disease comprised transglutaminase 2 antibodies >10× the upper limit of normal, positive endomysium antibodies, and appropriate genetics without requirement of symptoms. The diagnosis was based on intestinal biopsy.

resultsThe diagnosis of coeliac disease was established in 274 subjects. Of these, 59 high-risk subjects, 17 moderate-risk subjects, and 14 low-risk subjects fulfilled the "triple criteria". All had histologically proven coeliac disease, giving the criteria a positive predictive value of 100%. Altogether, 90 (33%) of all 274 newly diagnosed patients could have avoided biopsy, including 37% among high-risk, 20% among moderate-risk, and 48% among low-risk patients. No histological findings other than coeliac disease were found in the biopsies of "triple positive" subjects.

conclusionsCoeliac disease can reliably and safely be diagnosed without biopsy in adults fulfilling the "triple criteria" regardless of the pre-test probability. Revised criteria would enable the number of endoscopies to be reduced by one-third.

Indexed as

AdolescentAdultAgedAged, 80 and overAutoantibodiesBiopsyCeliac DiseaseCohort StudiesFemaleGTP-Binding ProteinsHumansMaleMiddle AgedProbabilityProtein Glutamine gamma Glutamyltransferase 2TransglutaminasesAutoantibodiesGTP-Binding ProteinsProtein Glutamine gamma Glutamyltransferase 2Transglutaminases

Identifiers

PMID30592070
OpenAlexW2907050231

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.