Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate
  • Jefferson Adams
    Jefferson Adams

    Why a Faster, Easier Celiac Test is Only Part of the Diagnostic Challenge

    Reviewed and edited by a celiac disease expert.

    Can an office-based point of care test (POCT) improve celiac disease detection and diagnosis? A new study says probably not for a while.

    Why a Faster, Easier Celiac Test is Only Part of the Diagnostic Challenge - Image: CC--Alden Chadwick
    Caption: Image: CC--Alden Chadwick

    Celiac.com 09/03/2018 - Can an office-based point of care test (POCT) improve celiac disease detection and diagnosis? A team of researchers recently set out to measure the diagnostic performance of an IgA/IgG-deamidated gliadin peptide (DGP)-based POCT for celiac disease detection, patient acceptability, and inter-observer variability of the POCT results.

    The research team included Michelle S. Lau MBChB, Peter D. Mooney MD, William L. White MBChB, Michael A. Rees BMedSci, Simon H. Wong MBChB, Marios Hadjivassiliou FRCP, Peter H. R. Green MD, Benjamin Lebwohl MD & David S. Sanders FRCP.  They are variously affiliated with the Academic Department of Gastroenterology, the Academic Department of Neurosciences and University of Sheffield, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield, UK, and with the Celiac Disease Centre at Columbia University Medical Centre in New York, NY, USA.

    Celiac.com Sponsor (A12):
    Beginning in 2013, and running through 2017, the team recruited patients who had been referred for secondary care with gastrointestinal symptoms, anemia and/or weight loss (group 1), along with a group of patients with self-reported gluten sensitivity, but unknown celiac disease status (group 2).  Every patient in the study received a POCT, tests for IgA-tissue transglutaminase (IgA-TTG), IgA-endomysial antibodies (IgA-EMA), total IgA levels, and a duodenal biopsy. 

    A total of 500 patients completed acceptability questionnaires, and the team compared inter-observer variability of the POCT results among five clinical staff for 400 cases.

    Group 1 included 1,000 patients. The team saw forty-one patients (4.1%) diagnosed with celiac disease. The sensitivities of the POCT, IgA-TTG, and IgA-EMA were 82.9, 78.1, and 70.7%; the specificities were 85.4, 96.3, and 99.8%. Group 2 included 61 patients. The POCT showed 100% sensitivity, but negative predictive value in detecting celiac disease in group 2. 

    A majority of patients preferred the POCT to a blood draw (90.4% to 2.8%). A Fleiss Kappa coefficient of 0.895 reflected good inter-observer agreement on the POCT results. The POCT had comparable sensitivity to a blood test, and accurately spotted all celiac disease cases in a gluten sensitive group. But, because its low specificity may could cause further unnecessary tests, it’s not good enough to take the place of blood testing.

    It turns out that spotting celiac disease is only part of the battle. Making sure to rule out people who don’t have celiac disease is equally important. That’s why it’s important that any diagnostic test be both sensitive, to spot celiac disease, and specific, to rule out celiac disease in those who don’t have it. 

    Until we get a PCOT with high enough sensitivity and specificity to make accurate celiac diagnosis and accurate elimination of those without celiac disease, the current blood testing regime will continue.

    Read more at: The American Journal of Gastroenterology; volume 113, pages1238–1246 (2018)



    User Feedback

    Recommended Comments

    Guest Judy

    How do I get this test?

    memamasan@comcast.net

    Link to comment
    Share on other sites
    Awol cast iron stomach

    Guest Judy,

    I haven't seen them anywhere yet personally. You may call a local celiac hospital or celiac lab testing clinic to inquire if they carry it. Based on Mr. Adams ' summary it's not yet recognized as standard care/practice/test and you may find it challenging to find a clinic or Dr. that currently uses POCT lab test.

    good luck

    Link to comment
    Share on other sites
    Awol cast iron stomach

    "The POCT showed 100% sensitivity, but negative predictive value in detecting celiac disease in group 2. "

    "The POCT had comparable sensitivity to a blood test, and accurately spotted all celiac disease cases in a gluten sensitive group."

    wow!

    While not current standard of care this would be a fit somewhere. maybe As an initial screening at health events or hospital tents at Local fairs or celiac awareness events. It will get people to next level of care for an appointment at a celiac hospital. As many of us believe there are quite a few people who are ill, but unaware celiac is the cause.

    Link to comment
    Share on other sites
    TinaE

    The problem with blood tests is that if you are gluten free it will come up negative. I get Dermatitis Herpetiformis horribly on both elbows if I eat wheat or have meds with iodine. Not a risk I am willing to take in order to get tested. Any suggestions?

    Link to comment
    Share on other sites


    Create an account or sign in to comment

    You need to be a member in order to leave a comment

    Create an account

    Sign up for a new account in our community. It's easy!

    Register a new account

    Sign in

    Already have an account? Sign in here.

    Sign In Now

  • Get Celiac.com Updates:
    Support Celiac.com:
    Donate
  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University. His articles, essays, poems, stories and book reviews have appeared in numerous magazines, journals, and websites, including North American Project, Antioch Review, Caliban, Mississippi Review, Slate, and more. He is the author of more than 2,500 articles on celiac disease. His university coursework includes studies in science, scientific methodology, biology, anatomy, physiology, medicine, logic, and advanced research. He previously devised health and medical content for Colgate, Dove, Pfizer, Sharecare, Walgreens, and more. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of numerous books, including "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

    >VIEW ALL ARTICLES BY JEFFERSON ADAMS

     


  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17-M):




  • Related Articles

    Jefferson Adams
    Celiac.com 02/27/2009 - A simple, reliable low-cost home screening test for celiac disease recently made its Canadian debut.
    According to health officials, about 1% of the population, or one out of every 100 Americans suffers from celiac disease. Currently, that total number of Americans with celiac disease stands somewhere near 3 million. Sadly, upwards of 97% of those affected remain undiagnosed.
    For people with celiac disease, eating gluten—a protein found in wheat, rye and barley—causes damage to the lining of the small intestine, preventing the uptake of nutrients.
    Delayed diagnosis can put people at risk for certain types of cancer and many other associated conditions, including infertility. Early diagnosis of celiac disease is actually quite easy and carries many advantages.

    Jefferson Adams
    Celiac.com 12/04/2015 (Updated 02/11/2019) - Note that since this article was originally published Panera changed their offerings from “gluten-free” to “gluten-friendly” due to the risk of cross-contamination, and their Web site indicates that their offering are not safe for celiacs. 
    In what may be good news for gluten-free bread lovers, Panera Bread, the national-fast casual restaurant that centers around freshly baked goods, is now testing out a new products to bring in gluten-free customers.
    The company plans to test a gluten-free Rosemary Focaccia Roll in 15 stores in the Detroit area, and plans to take the product nation-wide in the second half of 2016. To be successful, the chain will have to succeed where many others have failed; they will have to produce a high-q...


    Jefferson Adams
    Are Gluten ELISA Test Kits Wildly Inaccurate?
    Celiac.com 03/16/2016 - If you have celiac disease, particularly if you are highly sensitive to gluten exposure, you may rely on commercial ELISA test kits for gluten detection.
    There are a large variety of enzyme-linked immunosorbent assays (ELISAs) commercially available for gluten detection in food, including new formats and assays with antibodies against relevant gluten epitopes.
    But, how accurate are these test kits for gluten detection? How reliable are they for people with celiac disease? A team of researchers recently set out to evaluate the accuracy of 14 ELISA kits for gluten detection. The kits they tested cover the full range of the current commercially available ELISA test kits.
    The researcher team included Ilona D. Bruins Slot, Maria G. E. G. Bremer,...


    Celiac.com Sponsor: Review
    LetsGetChecked Home Celiac Disease Test Kit
    Celiac.com 08/31/2018 - Until recently the only way to get a proper screening for celiac disease would be to convince your doctor or health care provider to order the tests, and then pay a visit to the lab where they would draw a test tube or two full of blood. Depending on your situation, it can sometimes be difficult to convince your doctor or health care provider to actually order the tests. They can also be expensive, even if you are lucky enough to have decent health insurance coverage.
    Did you know that you can now use a LetsGetChecked home screening kit to carry out a full celiac disease screening in the privacy of your own home?  I recently took the opportunity to use their kit to re-screen my son for celiac disease, as it's been a while since his last screening, and he should ...


  • Recent Activity

    1. - Raquel2021 replied to Celiacsugh's topic in Related Issues & Disorders
      11

      gluten-free and continued upper left side pain after drinking wine

    2. - trents replied to Ems10's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      7

      Gluten free diet - are these symptoms normal?

    3. - Scott Adams replied to Ems10's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      7

      Gluten free diet - are these symptoms normal?

    4. - Scott Adams replied to Ems10's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      7

      Gluten free diet - are these symptoms normal?

    5. - Ems10 replied to Ems10's topic in Celiac Disease Pre-Diagnosis, Testing & Symptoms
      7

      Gluten free diet - are these symptoms normal?


  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      126,299
    • Most Online (within 30 mins)
      7,748

    Lozzaka20
    Newest Member
    Lozzaka20
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      120.9k
    • Total Posts
      69.3k

  • Celiac.com Sponsor (A22):




  • Who's Online (See full list)


  • Celiac.com Sponsor (A21):



  • Popular Now

    • Ems10
      7
    • Celiacsugh
    • llisa
      20
  • Popular Articles

    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
    • Scott Adams
  • Upcoming Events

×
×
  • Create New...