title: How often do hematologists consider celiac disease in iron-deficiency anemia? Results of a national survey.
abstract: BACKGROUND
  Celiac disease (CD) is underdiagnosed, and iron-deficiency anemia (IDA) is a common presentation of CD. No guidelines exist in the literature for screening for CD among those with IDA in the United States. We surveyed hematologists to deter- mine rates of CD screening in patients with IDA.
  
  
  METHODS
  A survey was e-mailed to members of the American Society of Hematology.
  
  
  RESULTS
  There were 385 complete responses from 4551 e-mails. Most respondents were practicing clinicians (74%), clinical researchers (10%), or laboratory researchers (6%). Specialists in benign hematology accounted for 45% of respondents, oncologists accounted for 33%, and specialists in malignant hematology accounted for 22%. The most common practice types were university-affiliated hospital (43%), private clinic (29%), community hospital (12%), and Veterans Affairs or military hospital (9%). Only 8.6% believed all patients with IDA should be screened for CD. Respondents who had completed their fellowship within 5 years were more likely than more experienced clinicians to believe that all patients with IDA should receive CD screening (OR, 2.8; CI; 1.1-7.5; P=.04). Having a higher volume of IDA patients per month also increased the likelihood of testing (P=.01). In multivariate analysis, specialists in malignant hematology (OR, 3.2; CI, 1.1-9.5; P=.04) and oncologists (OR, 3.5; CI, 1.3-9.5; P=.02) were more likely than specialists in benign hematology to screen all patients for CD, as were those who saw predominately pediatric patients with IDA vs adult patients (OR, 16.9; CI, 3.0-97.0; P=.002).
  
  
  CONCLUSIONS
  Practicing hematologists infrequently screen for CD in IDA. Physicians who have recently finished their fellowship and those who see a high volume of patients with IDA are more likely to screen for CD.
authors.affiliation: Columbia University Medical Center, New York, New York.
authors.forename: Scott
authors.initials: S
authors.lastname: Smukalla
authors.affiliation: Columbia University Medical Center, New York, New York.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lebwohl
authors.affiliation: Columbia University Medical Center, New York, New York.
authors.forename: J Gregory
authors.initials: JG
authors.lastname: Mears
authors.affiliation: MD Anderson Cancer Center, Houston, Texas.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Leslie
authors.affiliation: Columbia University Medical Center, New York, New York.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Green
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D010820:Physicians / Q000706:statistics & numerical data*