Case-finding in primary care for coeliac disease: Accuracy and cost-effectiveness of a rapid point-of-care test
| العنوان: | Case-finding in primary care for coeliac disease: Accuracy and cost-effectiveness of a rapid point-of-care test |
|---|---|
| المؤلفون: | Esteve i Comas, Maria, Rosinach, Merce, Llordés, Montserrat, Calpe, Judit, Montserrat, Glòria, Pujals, Mar, Cela, Abel, Carrasco García, Anna, Ibarra, Montserrat, Ruiz Ramirez, Pablo, Tristán, Eva, Arau, Beatriz, Ferrer, Carme, Mariné, Meritxell, Ribes Puig, Josepa, Fernández Bañares, Fernando, Primary Care Coeliac Disease Study Group |
| المصدر: | United European Gastroenterology Journal Dipòsit Digital de la UB Universidad de Barcelona |
| بيانات النشر: | SAGE Publications, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | medicine.medical_specialty, Cost effectiveness, diagnosis, Point-of-care testing, serology, Primary care, Coeliac disease, Serology, 03 medical and health sciences, 0302 clinical medicine, Diagnòstic, Internal medicine, Diagnosis, Medicine, Celiac disease, biology, business.industry, Gastroenterology, Original Articles, medicine.disease, Oncology, 030220 oncology & carcinogenesis, biology.protein, Case finding, Intraepithelial lymphocyte, 030211 gastroenterology & hepatology, point-of-care test, Malaltia celíaca, Antibody, business |
| الوصف: | Background: An on-site, rapid, fingertip, whole-blood point-of-care test (POCT) is attractive for active case-finding of coeliac disease (CD) in primary care because of its simplicity. Aim: The aim of this article is to assess the usefulness and cost-effectiveness of adult case-finding using a POCT based on deamidated gliadin peptide antibodies (IgA/IgG-DGP) in primary care for CD diagnosis. Methods: A case-finding study for CD was conducted by using an easy-to-use, on-site, whole-blood for IgA/IgG-DGP-based fingertip POCT compared with tTG2 in 350 individuals. Sample size was calculated based on 0.28% prevalence in the reference population. Duodenal biopsies for histology, intraepithelial lymphocytes and in situ deposition of tTG2 were obtained if tTG2 and/or POCT were positive. Accuracy and cost-effectiveness of strategies using serology or POCT were calculated. Results: Prevalence of CD was 1.14% (95% CI, 0.3-3.4), almost double what was previously observed. Four patients were diagnosed with CD. tTG2 was positive in three (0.85%) and POCT in 29 (8.2%). Sensitivity of POCT for CD was 100%, specificity 93%, PPV 14%, and NPV 100%. POCT followed by duodenal biopsy was the most cost-effective approach in our setting (standard diagnosis: E13,033/case; POCT þ duodenal biopsy: E7360/case). Conclusions: A negative POCT allows ruling out CD in primary care, making it suitable for case-finding. POCT strategy was the most cost effective. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4c62b6ee3ec6c2b810391814ee5fe373Test http://hdl.handle.net/2445/172457Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....4c62b6ee3ec6c2b810391814ee5fe373 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |