Evidence map›Paper›PMID 37273968›Full record

ArticleJournal of the Canadian Association of Gastroenterology2023

Review and Critical Appraisal of Clinical Practice Guidelines of Modalities Used in the Diagnosis of Celiac Disease.

Kennedy Graham, Dominica Gidrewicz, Justine M Turner, Donald R Duerksen, Maria Ines Pinto-Sanchez

Abstract read
In one paragraph

Article in Journal of the Canadian Association of Gastroenterology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Review
  2. Diagnosis and management of celiac disease.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Review
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

5 authors.

Kennedy GrahamDepartment of Medicine, Farncombe Family Digestive Health Institute, McMaster University, Hamilton, Ontario, Canada.
Dominica GidrewiczDepartment of Pediatrics, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
Justine M TurnerDepartment of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Donald R DuerksenDepartment of Internal Medicine, Section of Gastroenterology, University of Manitoba, Winnipeg, Manitoba, Canada.
Maria Ines Pinto-SanchezDepartment of Medicine, Farncombe Family Digestive Health Institute, McMaster University, Hamilton, Ontario, Canada.ORCID https://orcid.org/0000-0002-9040-9824

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: There is controversy over the recommendations for specific serological strategies implemented and the need for a biopsy to confirm celiac disease (CeD). We reviewed and appraised the current clinical practice guidelines (CPGs) to assess the quality and reliability of recommendations for CeD diagnosis in pediatric and adult populations. Methods: We searched databases, including MEDLINE, EMBASE, Web of Science, and CINAHL, between December 2010 and January 2021 for CPGs. Four independent reviewers extracted data. Appraisal of Guidelines Research and Evaluation (AGREE II) criteria were applied by two reviewers, and a standardized score was calculated for each of the six domains. A cut-off of 60% was used to identify high-quality guidelines. Results: A total of 654 records were identified, 10 of which were eligible for data extraction. Both adult and pediatric CPGs averaged above 70% for the domains of 'scope and purpose' and 'clarity and presentation'. For 'stakeholder involvement', the mean adult and pediatric CPG scores were below the cut-off. Only one adult-focused guideline exceeded the cut-off for the 'rigour of development' domain. 'Applicability' scores were most alarming, with adult CPGs averaging 21% and pediatric CPGs averaging 23%. Conclusion: Our review and appraisal of the CPGs for the diagnosis of CeD highlight significant discrepancies in clinical recommendations and some concerns regarding methodological rigour, particularly in stakeholder engagement, rigour, and applicability. Creating a Canadian guideline of high methodological quality that overcomes these weaknesses is critical to optimize patient care and ensuring accurate diagnoses in CeD.

Identifiers

PMID37273968
PMCPMC10235591

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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.