Department of Nutrition, University of Brasília, Brasília 70910-900, Brazil.
Brasilia University Hospital, University of Brasília, Brasília 70840-901, Brazil.
Nutrients. 2024 Jul 26;16(15):2428. doi: 10.3390/nu16152428.
This systematic review aimed to find the tool that best predicts celiac individuals' adherence to a gluten-free diet (GFD). The Transparent Reporting of Multivariable Prediction Models for Individual Prognosis or Diagnosis (TRIPOD-SRMA) guideline was used for the construction and collection of data from eight scientific databases (PubMed, EMBASE, LILACS, Web of Science, LIVIVO, SCOPUS, Google Scholar, and Proquest) on 16 November 2023. The inclusion criteria were studies involving individuals with celiac disease (CD) who were over 18 years old and on a GFD for at least six months, using a questionnaire to predict adherence to a GFD, and comparing it with laboratory tests (serological tests, gluten immunogenic peptide-GIP, or biopsy). Review articles, book chapters, and studies without sufficient data were excluded. The Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies (CHARMS) was used for data collection from the selected primary studies, and their risk of bias and quality was assessed using the Prediction Risk of Bias Assessment Tool (PROBAST). The association between the GFD adherence determined by the tool and laboratory test was assessed using the phi contingency coefficient. The studies included in this review used four different tools to evaluate GFD adherence: BIAGI score, Coeliac Dietary Adherence Test (CDAT), self-report questions, and interviews. The comparison method most often used was biopsy (n = 19; 59.3%), followed by serology (n = 14; 43.7%) and gluten immunogenic peptides (GIPs) (n = 4; 12.5%). There were no significant differences between the interview, self-report, and BIAGI tools used to evaluate GFD adherence. These tools were better associated with GFD adherence than the CDAT. Considering their cost, application time, and prediction capacity, the self-report and BIAGI were the preferred tools for evaluating GFD adherence.
本系统评价旨在寻找最佳工具来预测乳糜泻患者对无麸质饮食 (GFD) 的依从性。使用多变量预测个体预后或诊断透明报告 (TRIPOD-SRMA) 指南，于 2023 年 11 月 16 日从 8 个科学数据库（PubMed、EMBASE、LILACS、Web of Science、LIVIVO、SCOPUS、Google Scholar 和 Proquest）中收集数据和构建。纳入标准为：涉及年龄大于 18 岁且接受 GFD 治疗至少 6 个月的乳糜泻患者的研究；使用问卷预测 GFD 依从性，并将其与实验室检查（血清学检查、麸质免疫肽-GIP 或活检）进行比较；排除综述文章、书籍章节和数据不足的研究。使用系统评价预测模型研究关键评估和数据提取清单 (CHARMS) 从选定的原始研究中收集数据，并使用预测偏倚风险评估工具 (PROBAST) 评估其偏倚风险和质量。使用 phi 连续性系数评估工具确定的 GFD 依从性与实验室检查之间的关联。本综述纳入的研究使用四种不同的工具来评估 GFD 依从性：BIAGI 评分、乳糜泻饮食依从性测试 (CDAT)、自我报告问题和访谈。最常使用的比较方法是活检（n = 19；59.3%），其次是血清学（n = 14；43.7%）和麸质免疫肽 (GIPs)（n = 4；12.5%）。用于评估 GFD 依从性的访谈、自我报告和 BIAGI 工具之间没有显著差异。这些工具与 GFD 依从性的相关性优于 CDAT。考虑到成本、应用时间和预测能力，自我报告和 BIAGI 是评估 GFD 依从性的首选工具。
