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ORIGINAL ARTICLE
Minerva Gastroenterology 2022 March;68(1):91-7
DOI: 10.23736/S2724-5985.21.03037-0
Copyright © 2021 EDIZIONI MINERVA MEDICA
language: English
The GLU-10: a validated ten-point score to identify poorly instructed celiac patients in need of dietary interventions
Marta VERNERO 1, Annalisa SCHIEPATTI 1 ✉, Stiliano MAIMARIS 1, Francesca LUSETTI 1, Davide SCALVINI 1, Fabiola MEGANG 1, Maria L. NICOLARDI 1, Gian M. GABRIELLI 1, Elisa SPRIO 2, Paola BAIARDI 3, Federico BIAGI 1
1 Unit of Gastroenterology, Clinical Scientific Institutes Maugeri IRCCS, University of Pavia, Pavia, Italy; 2 Department of Internal Medicine, Foundation IRCCS Polyclinic San Matteo, Pavia, Italy; 3 Clinical Scientific Institutes Maugeri IRCCS, Pavia, Italy
BACKGROUND: A standard tool to assess patients’ knowledge about gluten and the gluten-free diet (GFD) is lacking.
METHODS: We aimed to develop and validate a questionnaire to assess GFD knowledge. A 10-point questionnaire (GLU10) covering different aspects of knowledge about gluten content in food/non-food products and the gluten-free living was developed. To validate this questionnaire, it was administered to adult celiac patients already instructed on gluten and the GFD and non-celiac controls. Patients were prospectively recruited at our Gastroenterology Outpatient Clinic between August 2020 and February 2021.
RESULTS: One hundred and six patients (52 celiac patients and 54 controls) participated in the validation phase. Celiac patients scored significantly higher than controls on the GLU10 Questionnaire (median 6 points vs. 2 points, P<0.001). Higher self-reported knowledge of the GFD was related to a higher score (P<0.001). ROC curve confirmed the ability of the GLU10 Questionnaire to discriminate between subjects with good and poor GFD knowledge (AUC=0.94, 95% CI: 0.90-0.98). A score of 5 was identified as the best cut-off (sensitivity 80.8%, specificity 94.4%). On multivariable logistic regression analysis, being a celiac patient (P<0.001) and having a university degree (P=0.04) were associated to a high GLU10 Score (≥5).
CONCLUSIONS: GLU10 is the first validated questionnaire for assessing knowledge of a GFD in celiac patients and the general population.
KEY WORDS: Diet, gluten-free; Glutens; Surveys and questionnaires; Celiac disease; Knowledge