Screening for Celiac Disease in an IBS Population
Bibliographic record
Abstract
Purpose: Celiac disease (CD) is a genetically predisposed immune-mediated disorder affecting primarily the GI tract and activated by ingestion of gluten contained in wheat, rye and barley. It may begin in childhood or adult life, and serologic studies indicate the prevalence is relatively common with estimates of 1% to 3% in the general population in Europe and the US. Symptoms are highly variable and may include abdominal pain, bloating, diarrhea, and constipation (1,2). Because these non-specific GI symptoms are also common features of IBS, CD may be undetected in an IBS population. Serologic markers suggestive of CD have been recommended for initial evaluation (1). Our aim was to identify IBS patients with possible celiac disease enrolled in a clinical trial evaluating a novel agent to treat IBS. Methods: Male and female patients ≥ 18 yrs with IBS per Rome II criteria were enrolled into an international placebo-controlled treatment trial of 8 weeks. All patients had a normal colon evaluation within 2 years of entering the study, and patients with known CD were excluded. During the 2-wk screening period for active IBS symptoms, patients had a serum sample analyzed for IgA antibodies to human TTG (tissue transglutaminase) using ELISA (Quest Diagnostics, Nichols Institute, Pharmacia/Scimedx Celikey TTG (IgA) antibody kit, sensitivity 96%, specificity 99%). A result of ≥ 5 units/ml was considered positive for purposes of excluding patients with possible CD from the treatment phase. Results: 1362 patients (1015/1362, 75% female) were enrolled into screening with the majority of patients coming from US, Canada, Germany, and Australia (1138/1362, 84%). IgA TTG antibody results were obtained for 1355 patients with 7 patients testing positive for CD: 6 females (4 white, 2 Hispanic) and 1 male (white). By history, 2 females were diarrhea-IBS and 1 female had constipation-IBS. Three females and 1 male had mixed diarrhea-constipation IBS. Conclusions: In this IBS population, IgA TTG antibody testing for CD suggests that the prevalence of CD in IBS (7/1355; 0.5%) is similar to the prevalence observed in general population studies. Cost of screening for CD in a clinical trial may not be justified given the small number of patients with possible CD. Further studies are warranted to confirm these findings.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
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".