Prashant Singh1, Ananya Arora2, Tor A Strand3, Daniel A Leffler1,4, Markku Mäki5, Ciaran P Kelly1, Vineet Ahuja6, Govind K Makharia6. 1. Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Boston. 2. Lady Hardinge Medical College. 3. Innlandet Hospital Trust, Lillehammer, Norway. 4. Takeda Pharmaceuticals Inc, Cambridge, MA. 5. Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital, Finland. 6. Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
Abstract
GOALS: To perform a systematic review and meta-analysis to estimate the overall diagnostic accuracy of point of care tests (POCTs) for diagnosing celiac disease (CD). BACKGROUND: Recently, POCTs for CD have been developed and are commercially available. Studies have reported significant variability in their sensitivity (70% to 100%) and specificity (85% to 100%). STUDY: We searched MEDLINE, EMBASE databases, and the Cochrane library through June 2017. Positive reference test was defined as villous atrophy along with positive celiac-specific serology and/or clinical improvement after gluten-free diet. Normal duodenal biopsy was defined as negative reference test. Bivariate random-effect model was used to present the summary estimates of sensitivities and specificities along with 95% confidence regions We assessed methodologic quality using the quality assessment of diagnostic accuracy studies-2 tool. RESULTS: The pooled sensitivity and specificity of all POCTs (based on tTG or DGP or tTG+Anti-gliadin antibodies) for diagnosing CD were 94.0% [95% confidence interval (CI), 89.9-96.5] and 94.4% (95% CI, 90.9-96.5), respectively. The pooled positive and negative likelihood ratios for POCTs were 16.7 and 0.06, respectively. The pooled sensitivity and specificity for IgA-tTG-based POCTs were 90.5% (95% CI, 82.3-95.1) and 94.8% (95% CI, 92.5-96.4), respectively. CONCLUSIONS: The pooled sensitivity and specificity of POCTs in diagnosing CD are high. POCTs may be used to screen for CD, especially in areas with limited access to laboratory-based testing. Further research assessing the diagnostic accuracy of individual POCTs and comparing it with other available POCTs is needed.
GOALS: To perform a systematic review and meta-analysis to estimate the overall diagnostic accuracy of point of care tests (POCTs) for diagnosing celiac disease (CD). BACKGROUND: Recently, POCTs for CD have been developed and are commercially available. Studies have reported significant variability in their sensitivity (70% to 100%) and specificity (85% to 100%). STUDY: We searched MEDLINE, EMBASE databases, and the Cochrane library through June 2017. Positive reference test was defined as villous atrophy along with positive celiac-specific serology and/or clinical improvement after gluten-free diet. Normal duodenal biopsy was defined as negative reference test. Bivariate random-effect model was used to present the summary estimates of sensitivities and specificities along with 95% confidence regions We assessed methodologic quality using the quality assessment of diagnostic accuracy studies-2 tool. RESULTS: The pooled sensitivity and specificity of all POCTs (based on tTG or DGP or tTG+Anti-gliadin antibodies) for diagnosing CD were 94.0% [95% confidence interval (CI), 89.9-96.5] and 94.4% (95% CI, 90.9-96.5), respectively. The pooled positive and negative likelihood ratios for POCTs were 16.7 and 0.06, respectively. The pooled sensitivity and specificity for IgA-tTG-based POCTs were 90.5% (95% CI, 82.3-95.1) and 94.8% (95% CI, 92.5-96.4), respectively. CONCLUSIONS: The pooled sensitivity and specificity of POCTs in diagnosing CD are high. POCTs may be used to screen for CD, especially in areas with limited access to laboratory-based testing. Further research assessing the diagnostic accuracy of individual POCTs and comparing it with other available POCTs is needed.
Authors: Govind K Makharia; Prashant Singh; Carlo Catassi; David S Sanders; Daniel Leffler; Raja Affendi Raja Ali; Julio C Bai Journal: Nat Rev Gastroenterol Hepatol Date: 2022-01-03 Impact factor: 46.802
Authors: Juuso Rusanen; Anne Toivonen; Jussi Hepojoki; Satu Hepojoki; Pekka Arikoski; Markku Heikkinen; Outi Vaarala; Jorma Ilonen; Klaus Hedman Journal: PLoS One Date: 2019-11-26 Impact factor: 3.240
Authors: Aarón D Ramírez-Sánchez; Ineke L Tan; B C Gonera-de Jong; Marijn C Visschedijk; Iris Jonkers; Sebo Withoff Journal: Int J Mol Sci Date: 2020-11-12 Impact factor: 5.923
Authors: Athena L Sheppard; Martha M C Elwenspoek; Lauren J Scott; Victoria Corfield; Hazel Everitt; Peter M Gillett; Alastair D Hay; Hayley E Jones; Susan Mallett; Jessica Watson; Penny F Whiting Journal: Aliment Pharmacol Ther Date: 2022-01-18 Impact factor: 9.524