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    Economic Benefits to Diagnosing Celiac Disease on a National Level


    Jefferson Adams

    Celiac.com 04/08/2009 - A study published in Journal of Insurance Medicine has delineated clear economic benefits to diagnosing celiac disease on a national level using a managed-care approach.


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    A team of researchers based at Columbia University Medical Center's Celiac Disease Center  recently set out to estimate the rate of celiac disease diagnosis and assess the economic benefits of diagnosis by reviewing retrospective cohort studies from a national managed-care-population database. The research team was made up of Peter H. R. Green, Alfred I. Neugut, Afzal J. Naiyer, Z. Collette Edwards, Susan Gabinelle, and Vijit Chinburapa.

    Using the data, the team isolated cases of newly diagnosed with celiac disease. They also isolated 3 control groups that included people without a diagnosis of celiac disease, but who showed 1, 2, or 3 or more symptoms common to the disease.

    They used claim, incident, and eligibility information from 10.2 million managed care individuals across America from January 1999 and December 2003. They quantified and compared direct standardized relative value based (RVU) medical cost and use of medical services across the whole of the 4 study base.

    What they found was that the rate of newly diagnosed cases of celiac disease had increased more than 100% over the study period.

    The celiac disease group showed substantial overall shrinkage in direct standardized medical costs compared with the control subjects.

    RVU-based medical costs for the celiac subjects were 24%, 33%, and 27% below cohort 1 (p,0.05), 29.0%, 38%, and 24% below cohort 2 (p,0.05), and 38%, 33%, and 31% below cohort 3 (p,0.01) for the 12-month, 24-month and 36-month post-diagnosis periods, respectively.

    The reduced costs correlated with a reduction in office visits, lab, diagnostic, imaging, and endoscopy procedures compared to the 3 other cohorts over the 3-year follow-up period.

    The researchers found increased rates of celiac disease diagnosis, which was tied directly to a substantial reduction in direct standardized RVU-based medical costs and use of selected health care services over the period of the study.

    Journal of Insurance Medicine 2008;40:218–228

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    Guest krista

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    Perhaps it will be the insurance companies that will be instrumental in getting routine celiac screening to be a part of our health care routine. The dollars that could be saved would be quite significant.

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    My own experience with stuttering is limited. I stuttered as a child when I became nervous, upset, or self-conscious. Although I have been gluten free for many years, I haven’t noticed any impact on my inclination to stutter when upset. I don’t know if they are related, but I have also had challenges with speaking when distressed and I have noticed a substantial improvement in this area since removing gluten from my diet. Nonetheless, I have long wondered if there is a connection between gluten consumption and stuttering. Having done the research for this article, I would now encourage stutterers to try a gluten free diet for six months to see if it will reduce or eliminate their stutter. Meanwhile, I hope that some investigator out there will research this matter, publish her findings, and start the ball rolling toward getting some definitive answers to this question.
    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

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    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023