On Thursday, Stanford pediatric gastroenterologist KT Park, MD, will participate in a Twitter chat about his latest research on celiac disease. The chat will be hosted by the American Gastroenterological Association and begins at 12 noon Pacific Time. Follow the conversation and ask questions using the hashtag #CeliacChat.
Park and colleagues at Stanford published findings (subscription required) in the latest issue of Clinical Gastroenterology and Hepatology showing that screening adolescents who are either symptomatic or at high-risk for celiac disease is more cost-effective than universal screening. Researchers compared both approaches in an effort to determine if one method would prove better at preventing bone loss and non-traumatic hip and vertebral fractures in celiac patients. Park, co-lead study author, discussed the team's findings in a American Gastroenterological Association release:
Our study showed that conducting systematic screening of patients at risk of celiac disease is more cost effective than screening all adolescents for the disease. We determined that adopting a universal screening strategy fails to increase the long-term quality of life of the population as a whole, and introduces potential harm from unnecessary endoscopic evaluations of healthy individuals.
There is an ongoing clinical concern in the GI community that the current practice of celiac disease screening misses a considerable proportion of asymptomatic patients due to the frequency of silent or inactive disease. However, implementing universal screening to prevent bone disease and subsequent non-traumatic fractures alone in undiagnosed or untreated celiac disease patients does not appear to be a viable health policy alternative to the standard of care.
Screening only those at risk was more cost effective, by a margin of $60, in preventing bone loss and fractures among patients with undiagnosed or subclinical disease. However, researchers noted that future analysis of risk and cost of other potential consequences of undiagnosed patients, such as anemia, infertility and malignancy, could alter the cost-effectiveness of universal screening for celiac disease.