P0454 EVALUATION OF CELIAC DISEASE SCREENING METHODS IN FIRST‐DEGREE RELATIVES
Bibliographic record
Abstract
Introduction: The aims of this prospective study were to determine the prevalence of celiac disease in first-degree relatives of biopsy proven subjects with celiac disease and to evaluate multiple screening tests for celiac disease. Methods: Each participating relative was subjected to the following tests: serum total IgA (nephelometry), IgA-endomysial antibody (EMA; IMMCO Diag, Buffalo, NY), IgG- and IgA-human red cell tissue transglutaminase antibody (IgA-& IgG-TtG; INOVA Diag, San Diego, CA), and small intestinal permeability by overnight urine lactulose/ mannitol ratio and sucrose excretion (ref 1). Individuals testing positive for any test were asked to undergo intestinal biopsy. Results: Requests to participate were sent to all (262) first-degree relatives of sixty-eight individuals with biopsy proven celiac disease that resided locally. Of these 202 (77%) enrolled in the study. Eight relatives already known to have biopsy proven celiac disease were not screened. None of the participants were IgA deficient. A total of 37(18%) relatives from 29 (43%) families screened positive. Of the 27 who agreed to undergo biopsy, 16 biopsies were diagnostic of celiac disease, two of Crohn’s disease and nine were normal. Symptoms were present in 6/16 (37.5%) cases found to have celiac disease. The sensitivity, specificity, PPV and NPV of the screening tests in comparison to biopsy are shown in Table 1. Identification of a positive IgA-TtG or an increased sucrose permeability was the most sensititive screening combination with the best NPV. Three subjects, who refused biopsy, were positive for four of the screening tests and very likely have celiac disease. The prevalence of celiac disease in Canadian first-degree relatives is at least 9.1% (24/262) and may be as high as 13.3% (27/202) if the three subjects with at least four positive screening tests are included and we limit our results to only subjects who enrolled. Conclusion: The prevalence of celiac disease in Canadian first-degree relatives is between nine and 13 %. The combination of IgA-TtG and sucrose permeability identified the greatest number with celiac disease with the fewest tests and negative biopsies.
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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 | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".