Validation of a French Version of the Quality of Life “Celiac Disease Questionnaire”

<div><p>Background and Objective</p><p>Celiac disease (CD) is a common chronic autoimmune disorder. Both the manifestations of the disease and the burden of the compulsory life-long gluten-free diet (GFD) have been shown to be associated with impairment of health-related quality of life. The objectives of this study were to provide a cross-cultural adaptation of the specific quality of life “Celiac Disease Questionnaire” (CDQ) and to analyze its psychometric properties.</p><p>Materials and Methods</p><p>A cross-cultural French adaptation of the CDQ (F-CDQ) was obtained according to the revised international guidelines. The questionnaire was administered at baseline to 211 patients with biopsy proven CD followed-up in a single tertiary referral centre. The questionnaire was also administered after 7 days and 6 months. Reliability (intraclass correlation coefficients (ICC), Cronbach's alpha and Bland and Altman graphical analysis), validity (factorial structure and Rasch analysis, convergent validity), and responsiveness (effect size) of the F-CDQ were studied.</p><p>Results</p><p>The reliability of the F-CDQ was excellent with ICC and Cronbach's alpha coefficients being between 0.79 and 0.94 for the four subscales and the total score. The factorial structure and the Rasch analysis showed that the four dimensions of the original instrument were retained. Correlations with external measures (a generic measure of quality of life, an anxiety and depression instrument, a self-assessed disease severity, and clinical manifestations) were all in the expected direction confirming the validity of the instrument. Responsiveness was studied and effect sizes ≥0.20 were demonstrated for most of the subscales for patients who reported improvement or deterioration after 6 months.</p><p>Conclusion</p><p>The F-CDQ retains the psychometric properties of the original instrument and should be useful in cross-national surveys and to assess outcome in clinical trials involving patients with CD.</p></div

Bland and Altman graphical analysis of the reproducibility of the total score of the French version of the “Celiac Disease Questionnaire” (F-CDQ).

<p>Mean total score of the two F-CDQ assessments (baseline and retest 7 days later for patients who stated that their health status was unchanged) plotted against the difference of these two measures. The horizontal dotted lines indicate the mean difference ± 1 SD.</p

Sensitivity to change of the French version of the “Celiac Disease Questionnaire” (F-CDQ).

<p>Sensitivity to change of the French version of the “Celiac Disease Questionnaire” (F-CDQ).</p

Baseline subscale and total scores of the French version of the “Celiac Disease Questionnaire” and reliability.

<p>F-CDQ: French version of the “Celiac Disease Questionnaire”; the scores were normalised, ranging from 0 (worst score) to 100 (best score) for each subscale and the total F-CDQ score;</p><p>*: ICC computation was limited to the 112 of the 144 patients who participated in the test-retest study and who stated that their health status had not changed significantly between the two assessments;</p><p>**: Cronbach's α coefficients were computed from baseline data for the 211 individuals; ICC: intraclass correlation coefficient; 95% CI: 95% confidence interval.</p

Associations between the French version of the “Celiac Disease Questionnaire” (F-CDQ) and the MOS-36 and the HAD questionnaires.

<p>MOS-SF36: medical outcome study short-form 36 items; HAD: hospital anxiety and depression scale; *: Spearman correlation coefficients. Negative correlations coefficients were expected between F-CDQ subscales scores and the HAD as these two instruments score in the opposite directions. P<0.0001 of all correlations coefficients.</p

Socio-demographic and clinical characteristics of the patients with celiac disease included in the validation study of the French version of the “Celiac Disease Questionnaire”.

<p>*: disease severity was assessed on a visual analogue scale (0–10) with 10 indicating the most severe disease; CD: celiac disease; IQR: interquartile range. The MOS-SF36 scores are presented both as raw score and as age- and sex-adjusted standardised scores using the French general population reference values for age (10-year interval groups) and gender, and expressed as standard deviations (SD).</p

Association of the subscale scores for the French version of the “Celiac Disease Questionnaire” (F-CDQ) with gender, self-assessment of celiac disease severity and number of disease manifestations.

<p>*: self-reported disease severity assessed on a visual analogue scale (0–10) with 10 indicating the most severe disease; the F-CDQ scores were normalised, ranging from 0 (worst score) to 100 (best score) for each subscale and the total F-CDQ score.</p

Additional file 2: of A novel data-driven workflow combining literature and electronic health records to estimate comorbidities burden for a specific disease: a case study on autoimmune comorbidities in patients with celiac disease

Evolution of the numbers of co-occurrences in time. The 15 first ranked autoimmune diseases (in red) which would have been included based on the literature available at various time points. Numbers of co-occurrences until the specified year, ranks in prevalence estimates from this study, ranks in number of MeSH terms co-occurrence with term ‘Celiac Disease’ in MEDLINE at specified years. First version of the clinical vignette related on a new analgesic to control pain in mild trauma injuries with the four experimental factors tested. Description of first clinical vignette and list of response options. (DOCX 17 kb

Additional file 1: of A novel data-driven workflow combining literature and electronic health records to estimate comorbidities burden for a specific disease: a case study on autoimmune comorbidities in patients with celiac disease

List of ATC codes used. Lists of Anatomical Therapeutic Chemical Classification System (ATC) codes used for autoimmune thyroiditis (levothy*) and for diabetes mellitus, Type 1 (insulin). (DOCX 13 kb

Application of Deamidated Gliadin Antibodies in the Follow-Up of Treated Celiac Disease

<div><p>Introduction</p><p>The role of serological tests such as IgA anti-transglutaminase autoantibodies has become increasingly important in celiac disease (CD) diagnosis. However, the efficiency of these tests for patient follow-up is controversial. We investigated the correlation of 12 different serological tests, including recent deamidated gliadin and actin IgA tests, with villous atrophy (VA) in a retrospective cohort of treated celiac patients.</p><p>Materials and Methods</p><p>Serum samples were collected from 100 treated CD patients who had intestinal biopsy in the course of their follow-up. Antibodies against transglutaminase, deamidated gliadin peptides, and native gliadin were measured, along with IgA anti-actin. The biopsy slides were all blind-reviewed and scored according to Marsh classification.</p><p>Results</p><p>For all deamidated gliadin and transglutaminase tests, we found that a positive result was significantly associated with persistence of intestinal VA, with a diagnostic efficacy up to 80%. Furthermore, antibodies titers directly correlated with the degree of VA, indicating a strong link between disease activity and presence of antibodies in the serum. Interestingly, the tests with the highest association with persistent VA were those for deamidated gliadin IgG. Using a test positivity pattern analysis, we were also able to identify several groups of patients with distinct antibody profiles that showed significant differences in intestinal damage and diet compliance.</p><p>Conclusions</p><p>Altogether, these results show that deamidated gliadin antibodies are strongly correlated with VA and should be considered valuable tools in CD follow-up and that multiplex serologic analysis for treated CD represents a promising tool for personalized patient management.</p></div