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Testing for coeliac disease rarely leads to a diagnosis: a population-based study.
Rouvroye, Maxine D; Oldenburg, Lotte; Slottje, Pauline; Joosten, Johanna H K; de Menezes, Renee X; Reinders, Marcel E; Bouma, Gerd.
Afiliação
  • Rouvroye MD; Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
  • Oldenburg L; Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
  • Slottje P; Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.
  • Joosten JHK; Department of General Practice, Academic Network of General Practice, Amsterdam UMC, Amsterdam, The Netherlands.
  • de Menezes RX; Department of General Practice, Academic Network of General Practice, Amsterdam UMC, Amsterdam, The Netherlands.
  • Reinders ME; Department of Epidemiology and Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
  • Bouma G; Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.
Scand J Prim Health Care ; 39(3): 315-321, 2021 Sep.
Article em En | MEDLINE | ID: mdl-34137353
ABSTRACT

BACKGROUND:

Coeliac disease (CD) has an estimated prevalence of ∼1% in Europe with a significant gap between undiagnosed and diagnosed CD. Active case finding may help to bridge this gap yet the diagnostic yield of such active case finding in general practice by serological testing is unknown.

OBJECTIVE:

The aim of this study was to determine (1) the frequency of diagnosed CD in the general population, and (2) to investigate the yield of active case finding by general practitioners.

METHODS:

Electronic medical records of 207.200 patients registered in 49 general practices in The Netherlands in 2016 were analysed. An extensive search strategy, based on International Classification of Primary Care codes, free text and diagnostic test codes was performed to search CD- or gluten-related contacts.

RESULTS:

The incidence of CD diagnosis in general practice in 2016 was 0.01%. The prevalence of diagnosed CD reported in the general practice in the Netherlands was 0.19%, and considerably higher than previously reported in the general population. During the one year course of the study 0.95% of the population had a gluten-related contact with their GP; most of them (72%) were prompted by gastrointestinal complaints. Serological testing was performed in 66% (n = 1296) of these patients and positive in only 1.6% (n = 21).

CONCLUSION:

The number of diagnosed CD patients in the Netherlands is substantially higher than previously reported. This suggests that the gap between diagnosed and undiagnosed patients is lower than generally assumed. This may explain that despite a high frequency of gluten-related consultations in general practice the diagnostic yield of case finding by serological testing is low.Key pointsThe diagnostic approach of GPs regarding CD and the diagnostic yield is largely unknownCase finding in a primary health care practice has a low yield of 1.6%CD testing was mostly prompted by consultation for gastrointestinal symptomsThere is a heterogeneity in types of serological test performed in primary care.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença Celíaca / Clínicos Gerais Tipo de estudo: Diagnostic_studies / Incidence_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Scand J Prim Health Care Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Holanda

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença Celíaca / Clínicos Gerais Tipo de estudo: Diagnostic_studies / Incidence_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Scand J Prim Health Care Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Holanda