Can a Quick and Easy Quiz Determine Gluten-free Diet Success?

Celiac.com 03/01/2012 - Currently, the best way to assess whether patients with celiac disease are actually maintaining a strict gluten-free diet is to have trained experts conduct a dietary interview. These interviews can vary in complexity, depending on the nature and number of the questions, and on the amount of medical expertise required to score the responses.

A team of researchers has developed a way to score gluten-free dietary adherence  based on answers to four quick and easy questions that can be assessed by non-expert personnel. The researchers recently set out to test the reliability of their questionnaire in a new group of patients.

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The research team includes F. Biagi, P.I. Bianchi, A. Marchese, L. Trotta, C. Vattiato, D. Balduzzi, G. Brusco, A. Andrealli, F. Cisarò, M. Astegiano, S. Pellegrino, G. Magazzù, C. Klersy, and G.R. Corazza.

They are affiliated with the Coeliac Centre/First Department of Internal Medicine of the Fondazione IRCCS Policlinico San Matteo at the University of Pavia in Pavia, Italy.

The scoring for the quiz is set up to verify adherence to a gluten-free diet. The questionnaire has a five-level score.

From March 2008 to January 2011, the team surveyed 141 celiac disease patients who were undergoing re-evaluation. Each patient was following on a gluten-free diet.

The team then compared survey scores with levels of both villous atrophy and endomysial antibodies (EMA). Patients with persistence of either villous atrophy (Fisher's exact, P < 0·001; test for trend, P < 0·001) or positive EMA (Fisher's exact, P = 0·001; test for trend, P = 0·018) showed the lowest scores, which indicates poor compliance with a gluten-free diet.

Given that the celiac patients have been well instructed on what a gluten-free diet means and on how to follow it, our questionnaire is a reliable and simple method to verify compliance to a gluten-free diet. The team did not share in the study abstract the exact questions included in the survey, so stay tuned to find out the exact questions the team is testing.

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