The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.
The Gluten Free Diet: Assessing Adherence in a Pediatric Celiac Disease Population
Open accessAbstract
Background: A strict, lifelong, gluten-free diet (GFD) remains the sole treatment for celiac disease (CD). The assessment of adherence to the GFD in pediatric studies is often based on self-report and visual analogue scales which lack proven validity. We sought to compare parental-report of GFD adherence to expert registered dietitian (RD) assessments, the best available standard. Methods: Parents of children with biopsy-proven CD scored their adherence to the GFD on a five-point Likert scale similar to that used in previous pediatric CD studies. Each family was then evaluated by an RD expert in CD management who conducted a comprehensive and standardized assessment and scored the family’s adherence. The agreement between parents and the RD was assessed using paired t test and intraclass correlation coefficient (ICC) based on their scores. Results: One hundred twenty-two children and their families participated in the study, with a median of 32 months on a GFD. Excellent adherence (score 5 out of 5) was attributed to 60.5% of the sample by the RD. The parents scored adherence higher than the RD by an average difference of 0.41 scale points (95% CI, 0.28–0.54; P < 0.001). The agreement between parents and the registered dietitian was poor (ICC = 0.21). Conclusion: Reliance on self-report through Likert scales for GFD adherence overestimates adherence and misses opportunities for patient and family education. Approximately 40% of children with CD have ongoing gluten exposure, highlighting the need for regular assessment by an RD expert in the GFD to identify education and counselling needs for children with CD.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“More recent studies have reported adherence rates in paediatric patients within the range described (137,139-141)”
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 [140]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Long‐term follow‐up of coeliac disease – what do coeliac patients want?
BEBB, J. R., LAWSON, A., KNIGHT, T., & LONG, R. G. (2006) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2006.02824.x · Cited by 70
Flagged first, then by citations
Research works printed but not linked: 18
- Hill, 2005, Guideline for the diagnosis and treatment of celiac disease in children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition, J Pediatr Gastroenterol Nutr, 40, 1, 10.1097/00005176-200501000-00001 · DOI
- Marsh, 1995, The natural history of gluten sensitivity: Defining, refining and re-defining, QJM, 88, 9
- Oberhuber, 1999, The histopathology of coeliac disease: Time for a standardized report scheme for pathologists, Eur J Gastroenterol Hepatol, 11, 1185, 10.1097/00042737-199910000-00019 · DOI
- Hoffenberg, 2003, A prospective study of the incidence of childhood celiac disease, J Pediatr, 143, 308, 10.1067/S0022-3476(03)00282-8 · DOI
- Rashid, 2005, Celiac disease: Evaluation of the diagnosis and dietary compliance in Canadian children, Pediatrics, 116, e754, 10.1542/peds.2005-0904 · DOI · Paper page
- Wagner, 2008, Quality of life in adolescents with treated coeliac disease: Influence of compliance and age at diagnosis, J Pediatr Gastroenterol Nutr, 47, 555, 10.1097/MPG.0b013e31817fcb56 · DOI
- Whitaker, 2009, Patient perceptions of the burden of coeliac disease and its treatment in the UK, Aliment Pharmacol Ther, 29, 1131, 10.1111/j.1365-2036.2009.03983.x · DOI
- Leffler, 2007, A prospective comparative study of five measures of gluten-free diet adherence in adults with coeliac disease, Aliment Pharmacol Ther, 26, 1227, 10.1111/j.1365-2036.2007.03501.x · DOI
- Hommel, 2008, Treatment regimen adherence in pediatric gastroenterology, J Pediatr Gastroenterol Nutr, 47, 526, 10.1097/MPG.0b013e318175dda1 · DOI
- Leonard, 2017, Value of IgA tTG in predicting mucosal recovery in children with celiac disease on a gluten-free diet, J Pediatr Gastroenterol Nutr, 64, 286, 10.1097/MPG.0000000000001460 · DOI · Paper page
- Hall, 2009, Systematic review: Adherence to a gluten-free diet in adult patients with coeliac disease, Aliment Pharmacol Ther, 30, 315, 10.1111/j.1365-2036.2009.04053.x · DOI
- Isaac, 2016, Managing the pediatric patient with celiac disease: A multidisciplinary approach, J Multidiscip Healthc, 9, 529, 10.2147/JMDH.S95323 · DOI
- 2005, National Institutes of Health Consensus Development Conference Statement on Celiac Disease, June 28–30, 2004, Gastroenterology, 128, S1, 10.1053/j.gastro.2005.02.007 · DOI
- Rajani, 2013, Patient and parent satisfaction with a dietitian- and nurse-led celiac disease clinic for children at the Stollery Children’s Hospital, Edmonton, Alberta, Can J Gastroenterol, 27, 463, 10.1155/2013/537160 · DOI
- Högberg, 2003, Better dietary compliance in patients with coeliac disease diagnosed in early childhood, Scand J Gastroenterol, 38, 751, 10.1080/00365520310003318 · DOI
- Butterworth, 2004, Factors relating to compliance with a gluten-free diet in patients with coeliac disease: Comparison of white Caucasian and South Asian patients, Clin Nutr, 23, 1127, 10.1016/j.clnu.2004.02.009 · DOI
- Casellas, 2006, Current epidemiology and accessibility to diet compliance in adult celiac disease, Rev Esp Enferm Dig, 98, 408, 10.4321/S1130-01082006000600002 · DOI
- Bridge, 1999, Increasing physicians’ awareness of the impact of statistics on research outcomes: Comparative power of the t test and and Wilcoxon Rank-Sum test in small samples applied research, J Clin Epidemiol, 52, 229, 10.1016/S0895-4356(98)00168-1 · DOI
Cited by
Sorted by citations
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 44
Metadata
- Authors
- Dowhaniuk, J. K., Mileski, H., Saab, J., Tutelman, P., Thabane, L., & Brill, H.
- Affiliations
- McMaster University (CA)
- McMaster Children's Hospital (CA)
- Corresponding author
- Brill, Herbert
- Venue
- Journal of the Canadian Association of Gastroenterology
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-12-12
- Volume
- 3
- Issue
- 2
- Pages
- 67-73
- ISSN
- 2515-2084 (ISSN-L)
- 2515-2092
- PMC
- PMC7165265
- OpenAlex
- W2903740955
- Cited by
- 21
- References
- 1
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 1
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of the Canadian Association of Gastroenterology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Regional Medical Associates of Hamilton
- Topics
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Health Sciences › Medicine › Gastroenterology › Eosinophilic Esophagitis
- Keywords
- celiac disease, gluten-free diet, dietary adherence, pediatric celiac disease, parent self-report, gluten exposure, family education
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
