George DA, Hui LL, Rattehalli D, Lovatt T, Perry I, Green M, Robinson K, Walters JRF, Brookes MJ. The role of near-patient coeliac serology testing in the follow-up of patients with coeliac disease.
Frontline Gastroenterol 2014;
5:20-25. [PMID:
28839746 PMCID:
PMC5369711 DOI:
10.1136/flgastro-2013-100342]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 07/19/2013] [Accepted: 07/24/2013] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE
This pilot study was undertaken to assess the validity and effectiveness of near-patient coeliac immunological testing, compared to standard laboratory immunological techniques, used in the context of dietician-led coeliac disease follow-up clinics.
DESIGN
The study was designed in two phases, each assessing the near-patient test and standard laboratory immunological techniques. Phase 1 analysed stored serum samples; Phase 2 analysed whole blood from patients attending the dietician-led coeliac disease clinics.
SETTING
Patients were recruited from New Cross Hospital, Wolverhampton (n=50), and Imperial College London (n=30), between March 2010 and February 2011.
PATIENTS
Those with a diagnosis of coeliac disease for greater than 12 months attending dietician-led coeliac disease clinics.
INTERVENTIONS
In addition to whole blood taken for routine analysis, patients required a capillary finger-prick blood sample.
MAIN OUTCOME MEASURE
To determine if the whole blood and serum near-patient test results were in correlation with outcomes of standard laboratory evaluation.
RESULTS
Phase 1 demonstrated that the near-patient serum test had a sensitivity of 93.5% (95% CI 0.79% to 0.98%), specificity of 94.9% (0.83% to 0.99%), when compared to standard laboratory ELISA. Phase 2, involving patients whole blood, had a sensitivity of 77.8% (0.45% to 0.93%), and specificity of 100% (0.94% to 1%).
CONCLUSIONS
This pilot study has demonstrated that there appears to be a role for near-patient testing in coeliac disease, but further studies are recommended.
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