title: Evidence-Informed Expert Recommendations for the Management of Celiac Disease in Children.
abstract: Although the need for effective long-term follow-up for patients with celiac disease (CD) has been recognized by many expert groups, published practice guidelines have not provided a clear approach for the optimal management of these patients. In an attempt to provide a thoughtful and practical approach for managing these patients, a group of experts in pediatric CD performed a critical review of the available literature in 6 categories associated with CD to develop a set of best practices by using evidence-based data and expert opinion. The 6 categories included the following: bone health, hematologic issues, endocrine problems, liver disease, nutritional issues, and testing. Evidence was assessed by using standardized criteria for evaluating the quality of the data, grade of evidence, and strength of conclusions. Over 600 publications were reviewed, and 172 were chosen for inclusion. The thorough review of the results demonstrated that the quality of the data available was often insufficient to provide unequivocal best practices. However, using the available data and the clinical experience of the panel, a practical framework for the management of children with CD was created. These recommendations were developed by our expert panel and do not necessarily reflect the policy of the American Academy of Pediatrics. The potential usefulness of these best practices is underscored by the fact that consensus, measured by the outcome of anonymous voting, was reached by the panel for 24 of the 25 questions. We hope that these best practices may be useful to the pediatric gastroenterology and larger general pediatric communities.
authors: Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's National Health Systems, Washington, District of Columbia; butzner@ucalgary.ca.
authors: John
authors: J
authors: Snyder
authors: Division of Paediatric Gastroenterology, Hepatology and Nutrition, University of Calgary, Calgary, Alberta, Canada;
authors: J Decker
authors: JD
authors: Butzner
authors: Division of Pediatric Gastroenterology, Hepatology and Nutrition, New York-Presbyterian Hospital, Columbia University, New York, New York;
authors: Amy R
authors: AR
authors: DeFelice
authors: Division of Pediatric Gastroenterology, Hepatology and Nutrition, Massachusetts General Hospital for Children, Boston, Massachusetts;
authors: Alessio
authors: A
authors: Fasano
authors: Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Chicago Medical Center, Chicago, Illinois;
authors: Stefano
authors: S
authors: Guandalini
authors: Digestive Health Institute, Children's Hospital Colorado, Aurora, Colorado; and.
authors: Edwin
authors: E
authors: Liu
authors: Division of Pediatric Gastroenterology, Hepatology and Nutrition, Rady Children's Hospital and University of California San Diego School of Medicine, San Diego, California.
authors: Kimberly P
authors: KP
authors: Newton
mesh_terms: D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D002648:Child; D019317:Evidence-Based Medicine; D006801:Humans