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Usefulness of symptoms to screen for celiac disease
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.ORCID iD: 0000-0003-2441-2395
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
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2014 (English)In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 133, no 2, 211-218 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2014. Vol. 133, no 2, 211-218 p.
Keyword [en]
case-finding, celiac disease, questionnaire, screening, symptom
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-88852DOI: 10.1542/peds.2012-3765ISI: 000333413600006PubMedID: 24420802OAI: oai:DiVA.org:umu-88852DiVA: diva2:717714
Available from: 2014-05-16 Created: 2014-05-16 Last updated: 2017-12-05Bibliographically approved

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Rosén, AnnaSandström, OlofStenlund, HansIvarsson, Anneli

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