Evidence map›Paper›PMID 31324159›Full record

Observational studyBMC pediatrics2019

Survey of the initial management of celiac disease antibody tests by ordering physicians.

Kathryn Potter, Lawrence de Koning, J Decker Butzner, Dominica Gidrewicz

Abstract readObservational Study
In one paragraph

Observational study in BMC pediatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. A Clinician's Guide to Gluten Challenge.Journal of pediatric gastroenterology and nutrition · 2023
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kathryn PotterDepartment of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Lawrence de KoningDepartment of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.
J Decker ButznerDepartment of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Dominica GidrewiczDepartment of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada. Dominica.gidrewicz@ahs.ca.ORCID 0000-0002-5846-9472

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAppropriate interpretation of a positive celiac antibody test by an ordering physician is important in order to institute proper management. We evaluated why children with an initial positive celiac serology were not referred for diagnostic biopsy or followed with serial testing by the ordering physician.

methodsConsecutive celiac serologies in all patients less than 18 years of age were evaluated over 3.5 years and 775 children with a positive tissue transglutaminase antibody (TTG) were identified. If no management of a positive TTG could be identified, a survey was sent to the ordering physician. Responses were categorized as appropriate or inappropriate management.

resultsOf the 775 patients with a positive TTG, 193 (24.9%, 95% CI 21.9-28.1%) received no follow-up management. We contacted 173 ordering physicians and 120 (69%) responded. Of the 120 responses, 55 patients (45.8%, 95% CI 36.8-55.1%) were managed appropriately and 46 (38.3%, 95% CI 29.7-47.7%) were considered to be inappropriately managed when no repeat TTG was obtained within 18 months. Reasons for inappropriate management included: screen considered to be false positive (44.7%), patient was not experiencing symptoms of celiac disease (31.6%), symptoms had resolved (15.8%), results were not indicative of celiac disease (26.3%) and patients started a gluten-free diet with no evaluation of response (15.8%). In 19 patients the TTG was not acted upon for technical reasons.

conclusionsPositive TTGs require appropriate interventions. These include: subspecialist referral for further evaluation and/or repeat testing to evaluate: 1) treatment response or 2) patients with minimal or no symptoms.

Indexed as

Health Care SurveysPractice Patterns, Physicians'AdolescentAlbertaAttitude of Health PersonnelAutoantibodiesAutoantigensBiopsyCeliac DiseaseChildChild, PreschoolDiet, Gluten-FreeDisease ManagementFemaleGastroenterologyGTP-Binding ProteinsAutoantibodiesAutoantigensGTP-Binding ProteinsProtein Glutamine gamma Glutamyltransferase 2TransglutaminasesCeliac diseaseDiagnosisPediatricTissue transglutaminase

Identifiers

PMID31324159
PMCPMC6639898

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.