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Evidence-Based Medicine 2007;12:155; doi:10.1136/ebm.12.5.155
Copyright © 2007 by the BMJ Publishing Group Ltd.
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Clinical prediction guide

Pre-endoscopic serological test with duodenal biopsy in high risk patients had high sensitivity and low specificity for coeliac disease

Hopper AD, Cross SS, Hurlstone DP, et al. Pre-endoscopy serological testing for coeliac disease: evaluation of a clinical decision tool. BMJ 2007;334:729.[Abstract/Free Full Text]

Q Does a clinical decision tool (CDT) based on pre-endoscopic serological testing with duodenal biopsy for high risk patients accurately diagnose coeliac disease?

Clinical impact ratings Gastroenterology *****{star}{star} IM/Ambulatory care *****{star}{star}

Key Words: celiac disease • decision support techniques • gastroscopy

The first 150 words of the full text of this article appear below.

METHODS
Formula Design: 2 cohort studies, 1 for derivation and 1 for validation.

Formula Setting: endoscopy department at the Royal Hallamshire Hospital, Sheffield, UK.

Formula Patients: 1464 patients in the retrospective derivation cohort and 2000 patients 16–94 years of age (mean age 56 y, 58% women) in the prospective validation cohort who were referred for gastroscopy. Exclusion criteria were previously known coeliac disease, coagulopathy (international normalised ratio >1.3 or platelets <80 x 109/l), active gastrointestinal bleeding, or suspected cancer.

Formula Description of prediction guide: the CDT combined pre-endoscopic serological testing (tissue transglutaminase [TTG] antibody) and assessment of symptoms to identify patients at high or low risk of coeliac disease. The CDT was modified in the validation cohort to include duodenal biopsy for all high risk patients. Patients were at high risk if they had indications for weight loss, anaemia (haemoglobin level <120 g/l in women or <130 g/l in men), or diarrhoea (bowel movement . . . [Full text of this article]

Nina Ruth Lewis, MD, Richard F A Logan, MD

Queen’s Medical Centre,
Nottingham, UK






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Copyright © 2007 by the BMJ Publishing Group Ltd.