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Determining whether coeliac disease case-finding in primary care is better than random testing: a retrospective study
1Associate Specialist, Department of Gastroenterology, York Teaching Hospital NHS Foundation Trust, York, UK.
Case-finding for coeliac disease in primary care is no more effective than random population testing. Improved education on coeliac disease indications is necessary for both the public and physicians.
Area of Science:
- Gastroenterology
- Public Health
- Diagnostic Medicine
Background:
- Over 75% of coeliac disease patients in the UK remain undiagnosed, representing a significant public health challenge.
- Undiagnosed coeliac disease can lead to serious long-term health complications.
Purpose of the Study:
- To evaluate the effectiveness of case-finding strategies for coeliac disease in primary care settings.
- To compare case-finding with random testing for identifying coeliac disease.
Main Methods:
- A pragmatic study analyzed coeliac serology testing referrals and indications across 38 GP practices over 12 months.
- Follow-up data was collected for 12 months to track positive serology conversion to duodenal biopsy.
Main Results:
- Case-finding for coeliac disease in primary care demonstrated no significant advantage over random population testing.
- Only 71% of individuals with positive coeliac serology proceeded to a duodenal biopsy within the subsequent year.
Conclusions:
- Enhanced education for the public and primary care physicians regarding coeliac disease diagnostic indications is crucial.
- Primary care settings may not be the optimal environment for effective coeliac disease case-finding.
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