Navigation Links
Low adherence to biopsy guidelines affects celiac disease diagnosis in the United States
Date:7/7/2011

NEW YORK, NY (July 6, 2011) - A new study has found that most patients undergoing biopsy of the small intestine do not have the recommended number of samples to diagnose celiac disease. The study, published in the July 2011 issue of Gastrointestinal Endoscopy, analyzed a national database of biopsy specimens maintained by Caris Life Sciences (Irving, TX). More than 100,000 patients had a biopsy of the small intestine, but only 35 percent of them had at least four samples taken, the number recommended by professional guidelines.

Celiac disease is common, affecting approximately 1 percent of the population in the United States. However, the vast majority of patients with celiac disease in the United States have not been diagnosed. Many of these patients seek health care for symptoms including diarrhea, weight loss, or fatigue due to anemia. The diagnosis of celiac disease is made by biopsy of the small intestine, but factors related to the performance of biopsy may contribute to the under-diagnosis of celiac disease in the United States.

"Celiac disease can affect the small intestine in a patchy distribution, and so just one or two biopsy samples could potentially miss the evidence of the disease," said lead author Benjamin Lebwohl, MD, MS, a gastroenterologist at the Celiac Disease Center at Columbia University Medical Center, in New York. Dr. Lebwohl and co-authors aimed to measure the practice of small intestinal biopsy in the United States. The Caris pathology database consists of specimens submitted by gastroenterologists from 43 states as well as Puerto Rico and the District of Columbia. The team also compared the diagnosis rate among patients who had at least four specimens submitted, in accordance with guidelines.

The investigators identified 132,352 individuals who underwent biopsy between 2006 and 2009, for a variety of medical indications, including diarrhea, abdominal pain, esophageal reflux, and anemia. Only 35 percent of this group had at least four specimens submitted, and the most common number of specimens submitted was two. But adhering to the recommendation of submitting at least four specimens more than doubled the diagnosis rate of celiac disease.

Even when physicians indicated that they were suspicious of celiac disease (e.g., when patients had positive celiac disease blood tests), fewer than 40 percent of patients had at least four specimens submitted; the diagnosis was increased sevenfold when the guidelines were followed.

"The process of increasing the number of specimens from two to four takes approximately one extra minute during endoscopy," said Dr. Lebwohl. Given the high incremental yield of submitting at least four specimens, taking this extra minute appears to be justified.

"In this study we identified just one of the factors contributing to the high rate of under-diagnosis of celiac disease in the United States. We plan on studying other physician-related factors that may also be operative," said Dr. Peter Green, Director of the Celiac Center Columbia University Medical Center, who was also an author on the paper.


'/>"/>

Contact: Cynthai Beckman
cb2280@columbia.edu
646-812-1212
Columbia University Medical Center
Source:Eurekalert

Related biology news :

1. Link between fracture prevention and treatment adherence not fully understood by patients
2. Novel technique changes lymph node biopsy, reduces radiaiton exposure
3. Novel technique changes lymph node biopsy, reduces radiation exposure
4. Montana State grads work helps diagnose skin cancer without a biopsy
5. Multicolor quantum dots aid in cancer biopsy diagnosis
6. Microfluidics-imaging platform detects cancer growth signaling in minute biopsy samples
7. Guidelines urge physical activity during pregnancy
8. The International Society for Stem Cell Research releases new guidelines
9. Publication sets guidelines across cancer therapies: Ensuring the best in patient management
10. Coral Disease Handbook: Guidelines for Assessment, Monitoring and Management
11. First comprehensive guidelines for managing medullary thyroid carcinoma published in Thyroid journal
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/5/2017)... , April 5, 2017  The Allen Institute for ... Cell Explorer: a one-of-a-kind portal and dynamic digital window ... imaging data, the first application of deep learning to ... stem cell lines and a growing suite of powerful ... for these and future publicly available resources created and ...
(Date:4/3/2017)...  Data captured by IsoCode, IsoPlexis Corporation,s ... statistically significant association between the potency of ... objective response of cancer patients post-treatment. The ... cancer patients will respond to CAR-T cell ... to improve both pre-infusion potency testing and cell ...
(Date:3/29/2017)... the health IT company that operates the largest health ... today announced a Series B investment from BlueCross BlueShield ... investment and acquisition accelerates higi,s strategy to create the ... activities through the collection and workflow integration of ambient ... secures data today on behalf of over 36 million ...
Breaking Biology News(10 mins):
(Date:10/11/2017)... ... October 11, 2017 , ... At ... Purple announced Dr. Suneel I. Sheikh, the co-founder, CEO and chief research scientist ... has been selected for membership in ARCS Alumni Hall of Fame . ...
(Date:10/11/2017)... ... ... a basic first aid supply for any work environment, but most personal eye wash can ... a dangerous substance enters both eyes? It’s one less decision, and likely quicker response time ... , “Whether its dirt and debris, or an acid or alkali, getting anything in your ...
(Date:10/11/2017)... ... October 11, 2017 , ... ... it will be hosting a Webinar titled, “Pathology is going digital. Is your ... on digital pathology adoption best practices and how Proscia improves lab economics and ...
(Date:10/11/2017)... Netherlands and LAGUNA HILLS, Calif. ... Institute of Cancer Research, London (ICR) ... MMprofiler™ with SKY92, SkylineDx,s prognostic tool to risk-stratify patients with ... known as MUK nine . The University of ... which is partly funded by Myeloma UK, and ICR will ...
Breaking Biology Technology: