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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 ★★★★★☆☆ IM/Ambulatory care ★★★★★☆☆
METHODS
Design:
2 cohort studies, 1 for derivation and 1 for validation.
Setting:
endoscopy department at the Royal Hallamshire Hospital, Sheffield, UK.
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.
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 …
Footnotes
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For correspondence: Dr A D Hopper, Royal Hallamshire Hospital, United Kingdom. andydhopper{at}aol.com
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Source of funding: no external funding.
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