A score that verifies adherence to a gluten-free diet: a cross-sectional, multicentre validation in real clinical life
Open accessAbstract
A dietary interview performed by expert personnel is the best method to check whether patients with coeliac disease follow a strict gluten-free diet (GFD). We previously developed a score based on four fast and simple questions that can be administered even by non-expert personnel. The aim of the present study is to verify the reliability of our questionnaire in a new cohort of patients. The questionnaire has a five-level score. From March 2008 to January 2011, the questionnaire was administered to 141 coeliac patients on a GFD, who were undergoing re-evaluation. The score obtained was compared with persistence of both villous atrophy and endomysial antibodies (EMA). The rate of lower scores was higher among the patients with persistence of either villous atrophy (Fisher's exact, P < 0·001; test for trend, P < 0·001) or positive EMA (Fisher's exact, P = 0·001; test for trend, P = 0·018). Given that the coeliac patients have been well instructed on what a GFD means and on how to follow it, our questionnaire is a reliable and simple method to verify compliance to a GFD.
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The Biagi questionnaire and CDAT have been validated for use in adults only.
“However, both have been validated for use in adults only and have shown weak sensibility to detect dietary transgressions in children; however, they may be useful to detect dietary transgressions in adolescents (136,137).”
From Gluten-free diet for pediatric patients with coeliac disease: A position paper from the ESPGHAN gastroenterology committee, special interest group in coeliac disease. (2024) · cites this paper as [134]
The Patients section (page unavailable) describes validation of the Biagi questionnaire in 141 coeliac patients with a mean age of 34, supporting an adult-focused validation. It does not establish that every participant was an adult or that the questionnaire has been validated for adults only. The paper does not validate CDAT; its References section merely lists a separate adult CDAT validation study. (LLM, conf=0.79)
Experimental — accuracy not yet measuredThe Biagi questionnaire and the Coeliac Dietary Adherence Test (CDAT) are shorter self-reported questionnaires.
“Shorter self-reported questionnaires are the Biagi questionnaire (134) and the Coeliac Dietary Adherence Test (CDAT) (135).”
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Research works printed but not linked: 1
- O'Mahony S, Howdle PD & Losowsky MS (1996) Review Article: management of patients with non-responsive coeliac disease. Aliment Pharmacol Ther 10, 671-680.
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Szakács, Z., Mátrai, P., Hegyi, P., Szabó, I., Vincze, Á., Balaskó, M., Mosdósi, B., Sarlós, P., Simon, M., Márta, K., et al. (2017) · PLOS ONE · doi:10.1371/journal.pone.0187526 · Cited by 35 · see citing works
Luque, V., Crespo‐Escobar, P., Hård af Segerstad, E. M., Koltai, T., Norsa, L., Roman, E., Vreugdenhil, A., Fueyo‐Díaz, R., & Ribes‐Koninckx, C. (2024) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1002/jpn3.12079 · Cited by 32 · see citing works
Comparison of Patients’ and Doctors’ Reports on Health‐related Quality of Life in Celiac Disease
Vriezinga, S. L., Farih, N., van der Meulen‐de Jong, A. E., Putter, H., Rings, E. H. H. M., Schaart, M. W., Schweizer, J. J., Wessels, M. M. S., & Mearin, M. L. (2017) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/mpg.0000000000001355 · Cited by 17 · see citing works
- Authors
- Biagi, F., Bianchi, P. I., Marchese, A., Trotta, L., Vattiato, C., Balduzzi, D., Brusco, G., Andrealli, A., Cisarò, F., Astegiano, M., Pellegrino, S., Magazzù, G., Klersy, C., & Corazza, G. R.
- Affiliations
- University of Pavia (IT)
- Ospedale Civile di Voghera (IT)
- University of Turin (IT)
- University of Messina (IT)
- Policlinico San Matteo Fondazione (IT)
- Corresponding author
- Biagi, Federico
- ORCID
- Venue
- British Journal of Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2012-02-10
- Volume
- 108
- Issue
- 10
- Pages
- 1884-1888
- ISSN
- 0007-1145 (ISSN-L)
- 1475-2662
- OpenAlex
- W2167487737
- Cited by
- 151
- References
- 0
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 21 · 2023: 13 · 2022: 10 · 2021: 19 · 2020: 22 · 2019: 2 · 2018: 7 · 2017: 9 · 2016: 5 · 2015: 6 · 2014: 11 · 2013: 5 · 2012: 3
- FWCI
- 7.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal Of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, cc-by-nd)
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Surgery › Eosinophilic Esophagitis
- Keywords
- gluten-free diet, celiac disease, dietary adherence, questionnaire validation, villous atrophy, anti-endomysial antibodies
- MeSH terms
- Adult, Antibodies, Celiac Disease, Female, Humans, Intestines, Male, Middle Aged, Models, Biological, Surveys and Questionnaires, Reproducibility of Results, Cohort Studies, Diet, Gluten-Free, Young Adult
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