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Usefulness of Symptoms to Screen for Celiac Disease

Rosen, Anna; Sandstrom, Olof; Carlsson, Annelie LU ; Hogberg, Lotta; Olen, Ola; Stenlund, Hans and Ivarsson, Anneli (2014) In Pediatrics 133(2). p.211-218
Abstract
OBJECTIVE: To describe the frequency of symptoms and associated conditions among screening-detected celiac disease (CD) cases and non-CD children and to evaluate questionnaire-based case-finding targeting the general population. METHODS: In a population-based CD screening of 12-year-olds, children and their parents completed questionnaires on CD-associated symptoms and conditions before knowledge of CD status. Questionnaire data for those who had their CD detected in the screening (n = 153) were compared with those of children with normal levels of CD markers (n = 7016). Hypothetical case-finding strategies were also evaluated. Questionnaires were returned by 7054 ( 98%) of the children and by 6294 ( 88%) of their parents. RESULTS:... (More)
OBJECTIVE: To describe the frequency of symptoms and associated conditions among screening-detected celiac disease (CD) cases and non-CD children and to evaluate questionnaire-based case-finding targeting the general population. METHODS: In a population-based CD screening of 12-year-olds, children and their parents completed questionnaires on CD-associated symptoms and conditions before knowledge of CD status. Questionnaire data for those who had their CD detected in the screening (n = 153) were compared with those of children with normal levels of CD markers (n = 7016). Hypothetical case-finding strategies were also evaluated. Questionnaires were returned by 7054 ( 98%) of the children and by 6294 ( 88%) of their parents. RESULTS: Symptoms were as common among screening-detected CD cases as among non-CD children. The frequency of children with screening-detected CD was similar when comparing the groups with and without any CD-related symptoms (2.1% vs 2.1%; P =.930) or CD-associated conditions (3.6% vs 2.1%; P =.07). Case-finding by asking for CD-associated symptoms and/or conditions would have identified 52 cases (38% of all cases) at a cost of analyzing blood samples for 2282 children (37%) in the study population. CONCLUSIONS: The current recommended guidelines for finding undiagnosed CD cases, so-called active case-finding, fail to identify the majority of previously undiagnosed cases if applied in the general population of Swedish 12- year-olds. Our results warrant further studies on the effectiveness of CD case-finding in the pediatric population, both at the clinical and population-based levels. Pediatrics 2014; 133: 211- 218 (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
case-finding, celiac disease, questionnaire, screening, symptom
in
Pediatrics
volume
133
issue
2
pages
211 - 218
publisher
American Academy of Pediatrics
external identifiers
  • wos:000333413600006
  • scopus:84893274411
ISSN
1098-4275
DOI
10.1542/peds.2012-3765
language
English
LU publication?
yes
id
ade2d45f-f310-49b4-a031-bb559530cc85 (old id 4470362)
date added to LUP
2014-07-01 07:38:02
date last changed
2017-08-06 04:07:41
@article{ade2d45f-f310-49b4-a031-bb559530cc85,
  abstract     = {OBJECTIVE: To describe the frequency of symptoms and associated conditions among screening-detected celiac disease (CD) cases and non-CD children and to evaluate questionnaire-based case-finding targeting the general population. METHODS: In a population-based CD screening of 12-year-olds, children and their parents completed questionnaires on CD-associated symptoms and conditions before knowledge of CD status. Questionnaire data for those who had their CD detected in the screening (n = 153) were compared with those of children with normal levels of CD markers (n = 7016). Hypothetical case-finding strategies were also evaluated. Questionnaires were returned by 7054 ( 98%) of the children and by 6294 ( 88%) of their parents. RESULTS: Symptoms were as common among screening-detected CD cases as among non-CD children. The frequency of children with screening-detected CD was similar when comparing the groups with and without any CD-related symptoms (2.1% vs 2.1%; P =.930) or CD-associated conditions (3.6% vs 2.1%; P =.07). Case-finding by asking for CD-associated symptoms and/or conditions would have identified 52 cases (38% of all cases) at a cost of analyzing blood samples for 2282 children (37%) in the study population. CONCLUSIONS: The current recommended guidelines for finding undiagnosed CD cases, so-called active case-finding, fail to identify the majority of previously undiagnosed cases if applied in the general population of Swedish 12- year-olds. Our results warrant further studies on the effectiveness of CD case-finding in the pediatric population, both at the clinical and population-based levels. Pediatrics 2014; 133: 211- 218},
  author       = {Rosen, Anna and Sandstrom, Olof and Carlsson, Annelie and Hogberg, Lotta and Olen, Ola and Stenlund, Hans and Ivarsson, Anneli},
  issn         = {1098-4275},
  keyword      = {case-finding,celiac disease,questionnaire,screening,symptom},
  language     = {eng},
  number       = {2},
  pages        = {211--218},
  publisher    = {American Academy of Pediatrics},
  series       = {Pediatrics},
  title        = {Usefulness of Symptoms to Screen for Celiac Disease},
  url          = {http://dx.doi.org/10.1542/peds.2012-3765},
  volume       = {133},
  year         = {2014},
}