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Minerva Gastroenterology 2021 Sep 22

DOI: 10.23736/S2724-5985.21.03037-0


language: English

The GLU-10: a validated ten-point score to identify poorly instructed coeliac 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 Luisa NICOLARDI 1, Gian Marco GABRIELLI 1, Elisa SPRIO 2, Paola BAIARDI 3, Federico BIAGI 1

1 Gastroenterology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri, IRCCS, University of Pavia, Pavia, Italy; 2 Department of Internal Medicine, IRCCS Policlinico San Matteo, Pavia, Italy; 3 Direzione Scientifica Centrale, Istituti Clinici Scientifici 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 coeliac patients already instructed on gluten and the GFD and non-coeliac controls. Patients were prospectively recruited at our gastroenterology outpatient clinic between August 2020 and February 2021.
RESULTS: One hundred and six patients (52 coeliac patients and 54 controls) participated in the validation phase. Coeliac 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 coeliac 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 coeliac patients and the general population.

KEY WORDS: Gluten-free diet; Gluten; Questionnaire; Coeliac disease; Knowledge

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