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Accuracy of potential diagnostic indicators for coeliac disease: a systematic review protocol

Accuracy of potential diagnostic indicators for coeliac disease: a systematic review protocol
Accuracy of potential diagnostic indicators for coeliac disease: a systematic review protocol
Introduction
Coeliac disease (CD) is a systemic immune-mediated disorder triggered by gluten in genetically predisposed individuals. CD is diagnosed using a combination of serology tests and endoscopic biopsy of the small intestine. However, because of nonspecific symptoms and heterogeneous clinical presentation, diagnosing CD is challenging. Early detection of CD through improved case-finding strategies can improve the response to a gluten-free diet, patients’ quality of life, and potentially reduce the risk of complications. However, there is a lack of consensus which groups may benefit from active case-finding.
Methods and analysis
We will perform a systematic review to determine the accuracy of diagnostic indicators (such as symptoms and risk factors) for CD in adults and children, and thus can help identify patients who should be offered CD testing. MEDLINE, Embase, Cochrane Library, and Web of Science will be searched from 1997 until 2020. Screening will be performed in duplicate. Data extraction will be performed by one and checked by a second reviewer. Disagreements will be resolved through discussion or referral to a third reviewer. We will produce a narrative summary of identified prediction models. Studies where 2x2 data can be extracted or reconstructed will be treated as diagnostic accuracy studies, i.e. the diagnostic indicators are the index tests and CD serology and/or biopsy is the reference standard. For each diagnostic indicator, we will perform a bivariate random effects meta-analysis of the sensitivity and specificity.
Ethics and dissemination
Results will be reported in peer-reviewed journals, academic and public presentations and social media. We will convene an implementation panel to advise on the optimum strategy for enhanced dissemination. We will discuss findings with Coeliac UK to help with dissemination to patients. Ethical approval is not applicable, as this is a systematic review and no research participants will be involved.
2044-6055
Elwenspoek, M.
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Jackson, Joni
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Dawson, Sarah
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Everitt, Hazel
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Gillett, Peter
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Hay, Alastair D.
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Jones, Hayley E.
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Lane, Deborah
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Mallett, Susan
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Robins, Gerry
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Sheppard, Athena
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Stubbs, Jo
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Thom, Howard
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Watson, Jessica
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Whiting, Penny
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Elwenspoek, M.
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Jackson, Joni
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Dawson, Sarah
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Everitt, Hazel
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Gillett, Peter
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Hay, Alastair D.
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Jones, Hayley E.
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Lane, Deborah
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Mallett, Susan
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Robins, Gerry
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Sheppard, Athena
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Stubbs, Jo
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Thom, Howard
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Watson, Jessica
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Whiting, Penny
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Elwenspoek, M., Jackson, Joni, Dawson, Sarah, Everitt, Hazel, Gillett, Peter, Hay, Alastair D., Jones, Hayley E., Lane, Deborah, Mallett, Susan, Robins, Gerry, Sheppard, Athena, Stubbs, Jo, Thom, Howard, Watson, Jessica and Whiting, Penny (2020) Accuracy of potential diagnostic indicators for coeliac disease: a systematic review protocol. BMJ Open. (In Press)

Record type: Article

Abstract

Introduction
Coeliac disease (CD) is a systemic immune-mediated disorder triggered by gluten in genetically predisposed individuals. CD is diagnosed using a combination of serology tests and endoscopic biopsy of the small intestine. However, because of nonspecific symptoms and heterogeneous clinical presentation, diagnosing CD is challenging. Early detection of CD through improved case-finding strategies can improve the response to a gluten-free diet, patients’ quality of life, and potentially reduce the risk of complications. However, there is a lack of consensus which groups may benefit from active case-finding.
Methods and analysis
We will perform a systematic review to determine the accuracy of diagnostic indicators (such as symptoms and risk factors) for CD in adults and children, and thus can help identify patients who should be offered CD testing. MEDLINE, Embase, Cochrane Library, and Web of Science will be searched from 1997 until 2020. Screening will be performed in duplicate. Data extraction will be performed by one and checked by a second reviewer. Disagreements will be resolved through discussion or referral to a third reviewer. We will produce a narrative summary of identified prediction models. Studies where 2x2 data can be extracted or reconstructed will be treated as diagnostic accuracy studies, i.e. the diagnostic indicators are the index tests and CD serology and/or biopsy is the reference standard. For each diagnostic indicator, we will perform a bivariate random effects meta-analysis of the sensitivity and specificity.
Ethics and dissemination
Results will be reported in peer-reviewed journals, academic and public presentations and social media. We will convene an implementation panel to advise on the optimum strategy for enhanced dissemination. We will discuss findings with Coeliac UK to help with dissemination to patients. Ethical approval is not applicable, as this is a systematic review and no research participants will be involved.

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Coeliac HTA review protocol_clean copy v1 - Accepted Manuscript
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More information

Accepted/In Press date: 28 August 2020

Identifiers

Local EPrints ID: 443752
URI: http://eprints.soton.ac.uk/id/eprint/443752
ISSN: 2044-6055
PURE UUID: 6faafe0e-10ea-492b-87f7-bd359fcfdf3f
ORCID for Hazel Everitt: ORCID iD orcid.org/0000-0001-7362-8403

Catalogue record

Date deposited: 10 Sep 2020 17:02
Last modified: 13 Dec 2021 02:46

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Contributors

Author: M. Elwenspoek
Author: Joni Jackson
Author: Sarah Dawson
Author: Hazel Everitt ORCID iD
Author: Peter Gillett
Author: Alastair D. Hay
Author: Hayley E. Jones
Author: Deborah Lane
Author: Susan Mallett
Author: Gerry Robins
Author: Athena Sheppard
Author: Jo Stubbs
Author: Howard Thom
Author: Jessica Watson
Author: Penny Whiting

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