EVALUATION OF CURRENT PRACTICE GUIDELINES FOR LONG-TERM FOLLOW-UP OF INDIVIDUALS WITH CELIAC DISEASE
Bibliographic record
Abstract
Background: The management of celiac disease consists of a strict gluten-free diet for life. If properly followed, the diet resolves symptoms and the nutritional deficiencies. It is generally recommended that individuals with celiac disease require careful long term follow-up. However, it is not clear what elements of disease status evaluation, laboratory investigations and self-management support should be included. Objective: To examine current practice guidelines and recommendations regarding follow-up of individuals with celiac disease. Methods: Guidelines issued by gastroenterological societies and associations and recommendations by experts were retrieved using Medline and other Internet search engines. Results: Practice guidelines were available from the American Gastroenterological Association (AGA), North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, National Institutes of Health Consensus Development Conference 2004, World Gastroenterology Organization, British Society for Gastroenterology (BSG) and the UK-based Primary Care Society for Gastroenterology (PCSG). Most guidelines recommend a scheduled, annual visit and measuring weight, height and body mass index. The BSG recommends only a review at times of stress, whether physical or emotional. Some recommend dietary review with a nutritionist. All recommend serial tissue-transglutaminase antibody (tTG) testing. The AGA and PCSG recommend annual haemoglobin, ferritin and folate checks. One expert recommends that hemoglobin, electrolytes, calcium, albumin, ferritin, folate, fat-soluble vitamins, liver function tests, parathyroid hormone and bone density measurement be performed annually on each patient (This panel of tests would cost about CDN$400 per patient). Conclusions: The current practice guidelines regarding the follow-up of patients with celiac disease vary greatly in their recommendations and many are not evidence-based. Prospective studies are required to develop rational, cost-effective and risk-stratified guidelines for long term follow-up of these patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.034 | 0.152 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.009 | 0.008 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".