Population screening for coeliac disease in primary care by district nurses using a rapid antibody test: diagnostic accuracy and feasibility study
Objective To evaluate the feasibility and diagnostic accuracy of screening for coeliac disease by rapid detection of IgA antibodies to tissue transglutaminase performed in primary care.Design District nurses screened 6 year old children using rapid antibody testing of finger prick blood. They also c...
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| Veröffentlicht in: | BMJ 2007-12, Vol.335 (7632), p.1244-1247 |
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| creator | Korponay-Szabó, Ilma R Szabados, Katalin Pusztai, Jánosné Uhrin, Katalin Ludmány, Éva Nemes, Éva Kaukinen, Katri Kapitány, Anikó Koskinen, Lotta Sipka, Sándor Imre, Anikó Mäki, Markku |
| description | Objective To evaluate the feasibility and diagnostic accuracy of screening for coeliac disease by rapid detection of IgA antibodies to tissue transglutaminase performed in primary care.Design District nurses screened 6 year old children using rapid antibody testing of finger prick blood. They also collected capillary blood samples for laboratory determination of IgA and IgG antibodies to endomysium and IgA antibodies to tissue transglutaminase. Children with positive rapid test results were directly sent for biopsy of the small intestine.Setting Primary care in Jász-Nagykun-Szolnok county, Hungary.Participants 2690 children (77% of 6 year olds living in the county) and 120 nurses.Main outcome measures Positivity for antibodies to endomysium or transglutaminase in the laboratory and coeliac disease confirmed at biopsy.Results 37 children (1.4%, 95% confidence interval 0.9% to 1.8%) had biopsy confirmed coeliac disease. Only five of these children had been diagnosed clinically before screening. Rapid testing had a 78.1% sensitivity (70.0% to 89.3%) and 100% specificity (88.4% to 100%) for a final diagnosis of coeliac disease by biopsy. Sensitivity was 65.1% (50.2% to 77.6%) and specificity was 100% (99.8% to 100%) compared with combined results of IgA and IgG laboratory tests. Trained laboratory workers detected 30 of the 31 newly diagnosed IgA competent patients with the rapid test kit used blindly. Median time to biopsy after a positive rapid test result was significantly shorter (20 days, range 4-148) than after a positive laboratory result (142 days, 70-256; P |
| doi_str_mv | 10.1136/bmj.39405.472975.80 |
| format | Article |
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They also collected capillary blood samples for laboratory determination of IgA and IgG antibodies to endomysium and IgA antibodies to tissue transglutaminase. Children with positive rapid test results were directly sent for biopsy of the small intestine.Setting Primary care in Jász-Nagykun-Szolnok county, Hungary.Participants 2690 children (77% of 6 year olds living in the county) and 120 nurses.Main outcome measures Positivity for antibodies to endomysium or transglutaminase in the laboratory and coeliac disease confirmed at biopsy.Results 37 children (1.4%, 95% confidence interval 0.9% to 1.8%) had biopsy confirmed coeliac disease. Only five of these children had been diagnosed clinically before screening. Rapid testing had a 78.1% sensitivity (70.0% to 89.3%) and 100% specificity (88.4% to 100%) for a final diagnosis of coeliac disease by biopsy. Sensitivity was 65.1% (50.2% to 77.6%) and specificity was 100% (99.8% to 100%) compared with combined results of IgA and IgG laboratory tests. Trained laboratory workers detected 30 of the 31 newly diagnosed IgA competent patients with the rapid test kit used blindly. Median time to biopsy after a positive rapid test result was significantly shorter (20 days, range 4-148) than after a positive laboratory result (142 days, 70-256; P<0.001). Children with coeliac disease detected at screening were smaller and had worse health status than their peers but they improved on a gluten-free diet.Conclusions A simple rapid antibody test enabled primary care nurses to detect patients with coeliac disease in the community who were not picked up in clinical care. Extra training is needed to improve sensitivity.</description><edition>International edition</edition><identifier>ISSN: 0959-8138</identifier><identifier>ISSN: 0959-8146</identifier><identifier>ISSN: 0959-535X</identifier><identifier>EISSN: 1468-5833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.39405.472975.80</identifier><identifier>PMID: 18063612</identifier><identifier>CODEN: BMJOAE</identifier><language>eng</language><publisher>London: British Medical Journal Publishing Group</publisher><subject>Antibodies ; Antibodies - blood ; Antigens ; Biological and medical sciences ; Biopsies ; Blood ; Celiac disease ; Celiac Disease - economics ; Celiac Disease - nursing ; Celiac Disease - prevention & control ; Child ; Children ; Children & youth ; Clinical Laboratory Techniques - economics ; Clinical Laboratory Techniques - standards ; Coeliac disease ; Community Health Nursing - economics ; Community Health Nursing - standards ; Cost-Benefit Analysis ; Diet ; Disease ; Epidemiology ; Feasibility Studies ; Gastroenterology ; General aspects ; Gluten ; Humans ; Hungary ; Immunoglobulin A - blood ; Immunoglobulin G - blood ; Immunoglobulins ; Immunologic Tests - economics ; Immunologic Tests - methods ; Immunologic Tests - standards ; Laboratories ; Mass Screening - economics ; Mass Screening - methods ; Medical diagnosis ; Medical sciences ; Medical screening ; Methods ; Miscellaneous ; Nurses ; Population ; Prevention and actions ; Primary care ; Primary health care ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Screening ; Screening tests ; Small intestine ; Symptoms ; Treatment Outcome</subject><ispartof>BMJ, 2007-12, Vol.335 (7632), p.1244-1247</ispartof><rights>BMJ Publishing Group Ltd 2007</rights><rights>Copyright 2007 BMJ Publishing Group Ltd.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright: 2007 (c) BMJ Publishing Group Ltd 2007</rights><rights>Copyright BMJ Publishing Group Dec 15, 2007</rights><rights>BMJ Publishing Group Ltd 2007 2007 BMJ Publishing Group Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b681t-22dd1a46495b2b2a9eacc24f97fe48043005d53ce2efaf59af62a247a9148b473</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmj.com/content/335/7632/1244.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://bmj.com/content/335/7632/1244.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,230,314,776,780,799,881,3183,23550,27901,27902,30976,30977,57992,58225,77342,77373</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19918831$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18063612$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Korponay-Szabó, Ilma R</creatorcontrib><creatorcontrib>Szabados, Katalin</creatorcontrib><creatorcontrib>Pusztai, Jánosné</creatorcontrib><creatorcontrib>Uhrin, Katalin</creatorcontrib><creatorcontrib>Ludmány, Éva</creatorcontrib><creatorcontrib>Nemes, Éva</creatorcontrib><creatorcontrib>Kaukinen, Katri</creatorcontrib><creatorcontrib>Kapitány, Anikó</creatorcontrib><creatorcontrib>Koskinen, Lotta</creatorcontrib><creatorcontrib>Sipka, Sándor</creatorcontrib><creatorcontrib>Imre, Anikó</creatorcontrib><creatorcontrib>Mäki, Markku</creatorcontrib><title>Population screening for coeliac disease in primary care by district nurses using a rapid antibody test: diagnostic accuracy and feasibility study</title><title>BMJ</title><addtitle>BMJ</addtitle><description>Objective To evaluate the feasibility and diagnostic accuracy of screening for coeliac disease by rapid detection of IgA antibodies to tissue transglutaminase performed in primary care.Design District nurses screened 6 year old children using rapid antibody testing of finger prick blood. They also collected capillary blood samples for laboratory determination of IgA and IgG antibodies to endomysium and IgA antibodies to tissue transglutaminase. Children with positive rapid test results were directly sent for biopsy of the small intestine.Setting Primary care in Jász-Nagykun-Szolnok county, Hungary.Participants 2690 children (77% of 6 year olds living in the county) and 120 nurses.Main outcome measures Positivity for antibodies to endomysium or transglutaminase in the laboratory and coeliac disease confirmed at biopsy.Results 37 children (1.4%, 95% confidence interval 0.9% to 1.8%) had biopsy confirmed coeliac disease. Only five of these children had been diagnosed clinically before screening. Rapid testing had a 78.1% sensitivity (70.0% to 89.3%) and 100% specificity (88.4% to 100%) for a final diagnosis of coeliac disease by biopsy. Sensitivity was 65.1% (50.2% to 77.6%) and specificity was 100% (99.8% to 100%) compared with combined results of IgA and IgG laboratory tests. Trained laboratory workers detected 30 of the 31 newly diagnosed IgA competent patients with the rapid test kit used blindly. Median time to biopsy after a positive rapid test result was significantly shorter (20 days, range 4-148) than after a positive laboratory result (142 days, 70-256; P<0.001). Children with coeliac disease detected at screening were smaller and had worse health status than their peers but they improved on a gluten-free diet.Conclusions A simple rapid antibody test enabled primary care nurses to detect patients with coeliac disease in the community who were not picked up in clinical care. Extra training is needed to improve sensitivity.</description><subject>Antibodies</subject><subject>Antibodies - blood</subject><subject>Antigens</subject><subject>Biological and medical sciences</subject><subject>Biopsies</subject><subject>Blood</subject><subject>Celiac disease</subject><subject>Celiac Disease - economics</subject><subject>Celiac Disease - nursing</subject><subject>Celiac Disease - prevention & control</subject><subject>Child</subject><subject>Children</subject><subject>Children & youth</subject><subject>Clinical Laboratory Techniques - economics</subject><subject>Clinical Laboratory Techniques - standards</subject><subject>Coeliac disease</subject><subject>Community Health Nursing - economics</subject><subject>Community Health Nursing - standards</subject><subject>Cost-Benefit Analysis</subject><subject>Diet</subject><subject>Disease</subject><subject>Epidemiology</subject><subject>Feasibility Studies</subject><subject>Gastroenterology</subject><subject>General aspects</subject><subject>Gluten</subject><subject>Humans</subject><subject>Hungary</subject><subject>Immunoglobulin A - blood</subject><subject>Immunoglobulin G - blood</subject><subject>Immunoglobulins</subject><subject>Immunologic Tests - economics</subject><subject>Immunologic Tests - methods</subject><subject>Immunologic Tests - standards</subject><subject>Laboratories</subject><subject>Mass Screening - economics</subject><subject>Mass Screening - methods</subject><subject>Medical diagnosis</subject><subject>Medical sciences</subject><subject>Medical screening</subject><subject>Methods</subject><subject>Miscellaneous</subject><subject>Nurses</subject><subject>Population</subject><subject>Prevention and actions</subject><subject>Primary care</subject><subject>Primary health care</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Screening</subject><subject>Screening tests</subject><subject>Small intestine</subject><subject>Symptoms</subject><subject>Treatment Outcome</subject><issn>0959-8138</issn><issn>0959-8146</issn><issn>0959-535X</issn><issn>1468-5833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>7QJ</sourceid><recordid>eNqNkktrFEEUhRtRTIj5BaIUirqasd4PF4IGnwR1QIO74nZ1daxJT9dY1S3O3_AXW50ZEhU0rmpxvnvqnsupqtsEzwlh8nG9Ws6Z4VjMuaJGibnG16p9wqWeCc3Y9WofG2FmmjC9Vx3mvMQYU6a0keJmtUc0lkwSul_9-BDXYwdDiD3KLnnfh_4UtTEhF30XwKEmZA_Zo9CjdQorSBvkIHlUbyZpSMENqB9T9hmNeRoGlGAdGgT9EOrYbNDg8_CkwHDaxzwEh8C5MYHbFKRBbXEPdejCsEF5GJvNrepGC132h7v3oPr08sXHo9ez4_ev3hw9O57VUpNhRmnTEOCSG1HTmoLxxZby1qjWc405w1g0gjlPfQutMNBKCpQrMITrmit2UD3d-q7HeuUb5_shQWd3IW2EYH9X-vDFnsZvlhKmsOLF4NHOIMWvYwlpVyE733XQ-zhmqyRnXBg2kQ__SUqDJcGYXQkKRanQVF8JUiyUxGQC7_0BLuOY-nLYwnBcckhZoPt_g4hSyhgizZSCbSmXYs7Jtxe3IthOrbSllfa8lXbbSqtxmbr765kvZ3YdLMCDHQDZQdcm6F3Il1z5XWtGCndnyy3zENOFXpJiLc59Zlu9tNJ_v9AhnVmpWFnm3cmRXSwWz0_M57d2Ufj5lp-2_p8kPwG0MhPr</recordid><startdate>20071215</startdate><enddate>20071215</enddate><creator>Korponay-Szabó, Ilma R</creator><creator>Szabados, Katalin</creator><creator>Pusztai, Jánosné</creator><creator>Uhrin, Katalin</creator><creator>Ludmány, Éva</creator><creator>Nemes, Éva</creator><creator>Kaukinen, Katri</creator><creator>Kapitány, Anikó</creator><creator>Koskinen, Lotta</creator><creator>Sipka, Sándor</creator><creator>Imre, Anikó</creator><creator>Mäki, Markku</creator><general>British Medical Journal Publishing Group</general><general>British Medical Association</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group Ltd</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7QJ</scope><scope>7T5</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20071215</creationdate><title>Population screening for coeliac disease in primary care by district nurses using a rapid antibody test: diagnostic accuracy and feasibility study</title><author>Korponay-Szabó, Ilma R ; Szabados, Katalin ; Pusztai, Jánosné ; Uhrin, Katalin ; Ludmány, Éva ; Nemes, Éva ; Kaukinen, Katri ; Kapitány, Anikó ; Koskinen, Lotta ; Sipka, Sándor ; Imre, Anikó ; Mäki, Markku</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b681t-22dd1a46495b2b2a9eacc24f97fe48043005d53ce2efaf59af62a247a9148b473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Antibodies</topic><topic>Antibodies - blood</topic><topic>Antigens</topic><topic>Biological and medical sciences</topic><topic>Biopsies</topic><topic>Blood</topic><topic>Celiac disease</topic><topic>Celiac Disease - economics</topic><topic>Celiac Disease - nursing</topic><topic>Celiac Disease - prevention & control</topic><topic>Child</topic><topic>Children</topic><topic>Children & youth</topic><topic>Clinical Laboratory Techniques - economics</topic><topic>Clinical Laboratory Techniques - standards</topic><topic>Coeliac disease</topic><topic>Community Health Nursing - economics</topic><topic>Community Health Nursing - standards</topic><topic>Cost-Benefit Analysis</topic><topic>Diet</topic><topic>Disease</topic><topic>Epidemiology</topic><topic>Feasibility Studies</topic><topic>Gastroenterology</topic><topic>General aspects</topic><topic>Gluten</topic><topic>Humans</topic><topic>Hungary</topic><topic>Immunoglobulin A - blood</topic><topic>Immunoglobulin G - blood</topic><topic>Immunoglobulins</topic><topic>Immunologic Tests - economics</topic><topic>Immunologic Tests - methods</topic><topic>Immunologic Tests - standards</topic><topic>Laboratories</topic><topic>Mass Screening - economics</topic><topic>Mass Screening - methods</topic><topic>Medical diagnosis</topic><topic>Medical sciences</topic><topic>Medical screening</topic><topic>Methods</topic><topic>Miscellaneous</topic><topic>Nurses</topic><topic>Population</topic><topic>Prevention and actions</topic><topic>Primary care</topic><topic>Primary health care</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Screening</topic><topic>Screening tests</topic><topic>Small intestine</topic><topic>Symptoms</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Korponay-Szabó, Ilma R</creatorcontrib><creatorcontrib>Szabados, Katalin</creatorcontrib><creatorcontrib>Pusztai, Jánosné</creatorcontrib><creatorcontrib>Uhrin, Katalin</creatorcontrib><creatorcontrib>Ludmány, Éva</creatorcontrib><creatorcontrib>Nemes, Éva</creatorcontrib><creatorcontrib>Kaukinen, Katri</creatorcontrib><creatorcontrib>Kapitány, Anikó</creatorcontrib><creatorcontrib>Koskinen, Lotta</creatorcontrib><creatorcontrib>Sipka, Sándor</creatorcontrib><creatorcontrib>Imre, Anikó</creatorcontrib><creatorcontrib>Mäki, Markku</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Korponay-Szabó, Ilma R</au><au>Szabados, Katalin</au><au>Pusztai, Jánosné</au><au>Uhrin, Katalin</au><au>Ludmány, Éva</au><au>Nemes, Éva</au><au>Kaukinen, Katri</au><au>Kapitány, Anikó</au><au>Koskinen, Lotta</au><au>Sipka, Sándor</au><au>Imre, Anikó</au><au>Mäki, Markku</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Population screening for coeliac disease in primary care by district nurses using a rapid antibody test: diagnostic accuracy and feasibility study</atitle><jtitle>BMJ</jtitle><addtitle>BMJ</addtitle><date>2007-12-15</date><risdate>2007</risdate><volume>335</volume><issue>7632</issue><spage>1244</spage><epage>1247</epage><pages>1244-1247</pages><issn>0959-8138</issn><issn>0959-8146</issn><issn>0959-535X</issn><eissn>1468-5833</eissn><eissn>1756-1833</eissn><coden>BMJOAE</coden><abstract>Objective To evaluate the feasibility and diagnostic accuracy of screening for coeliac disease by rapid detection of IgA antibodies to tissue transglutaminase performed in primary care.Design District nurses screened 6 year old children using rapid antibody testing of finger prick blood. They also collected capillary blood samples for laboratory determination of IgA and IgG antibodies to endomysium and IgA antibodies to tissue transglutaminase. Children with positive rapid test results were directly sent for biopsy of the small intestine.Setting Primary care in Jász-Nagykun-Szolnok county, Hungary.Participants 2690 children (77% of 6 year olds living in the county) and 120 nurses.Main outcome measures Positivity for antibodies to endomysium or transglutaminase in the laboratory and coeliac disease confirmed at biopsy.Results 37 children (1.4%, 95% confidence interval 0.9% to 1.8%) had biopsy confirmed coeliac disease. Only five of these children had been diagnosed clinically before screening. Rapid testing had a 78.1% sensitivity (70.0% to 89.3%) and 100% specificity (88.4% to 100%) for a final diagnosis of coeliac disease by biopsy. Sensitivity was 65.1% (50.2% to 77.6%) and specificity was 100% (99.8% to 100%) compared with combined results of IgA and IgG laboratory tests. Trained laboratory workers detected 30 of the 31 newly diagnosed IgA competent patients with the rapid test kit used blindly. Median time to biopsy after a positive rapid test result was significantly shorter (20 days, range 4-148) than after a positive laboratory result (142 days, 70-256; P<0.001). Children with coeliac disease detected at screening were smaller and had worse health status than their peers but they improved on a gluten-free diet.Conclusions A simple rapid antibody test enabled primary care nurses to detect patients with coeliac disease in the community who were not picked up in clinical care. Extra training is needed to improve sensitivity.</abstract><cop>London</cop><pub>British Medical Journal Publishing Group</pub><pmid>18063612</pmid><doi>10.1136/bmj.39405.472975.80</doi><tpages>4</tpages><edition>International edition</edition><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2137074 |
| source | Applied Social Sciences Index & Abstracts (ASSIA); Jstor Complete Legacy; MEDLINE; BMJ Journals - NESLi2; Alma/SFX Local Collection |
| subjects | Antibodies Antibodies - blood Antigens Biological and medical sciences Biopsies Blood Celiac disease Celiac Disease - economics Celiac Disease - nursing Celiac Disease - prevention & control Child Children Children & youth Clinical Laboratory Techniques - economics Clinical Laboratory Techniques - standards Coeliac disease Community Health Nursing - economics Community Health Nursing - standards Cost-Benefit Analysis Diet Disease Epidemiology Feasibility Studies Gastroenterology General aspects Gluten Humans Hungary Immunoglobulin A - blood Immunoglobulin G - blood Immunoglobulins Immunologic Tests - economics Immunologic Tests - methods Immunologic Tests - standards Laboratories Mass Screening - economics Mass Screening - methods Medical diagnosis Medical sciences Medical screening Methods Miscellaneous Nurses Population Prevention and actions Primary care Primary health care Public health. Hygiene Public health. Hygiene-occupational medicine Screening Screening tests Small intestine Symptoms Treatment Outcome |
| title | Population screening for coeliac disease in primary care by district nurses using a rapid antibody test: diagnostic accuracy and feasibility study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T21%3A56%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-jstor_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Population%20screening%20for%20coeliac%20disease%20in%20primary%20care%20by%20district%20nurses%20using%20a%20rapid%20antibody%20test:%20diagnostic%20accuracy%20and%20feasibility%20study&rft.jtitle=BMJ&rft.au=Korponay-Szab%C3%B3,%20Ilma%20R&rft.date=2007-12-15&rft.volume=335&rft.issue=7632&rft.spage=1244&rft.epage=1247&rft.pages=1244-1247&rft.issn=0959-8138&rft.eissn=1468-5833&rft.coden=BMJOAE&rft_id=info:doi/10.1136/bmj.39405.472975.80&rft_dat=%3Cjstor_pubme%3E20508512%3C/jstor_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1777991694&rft_id=info:pmid/18063612&rft_jstor_id=20508512&rfr_iscdi=true |